title: Long-term survival (>25 years) of deceased donor kidney transplant recipients: a single-center experience.
abstract: BACKGROUND
  The aim of this preliminary work is to analyze the clinical features of 52 patients with a functional transplanted kidney for >25 years (all first transplant and all deceased donor recipients) and to compare with a similar though more complete study from Hôpital Necker-Paris 2012.
  
  
  METHODS
  The mean graft survival at 25 years is 12.7% and at 30 years is 10%. The actual mean serum creatinine concentration is 1.3 mg/L. We analyzed recipient age (mean, 35.9 years) and gender (29 men and 23 women). Donor age was 26.7 ± 10.3 years. Seven patients (13.4%) were transplanted with 1 HLA mismatch, 42.3% with 2 mismatches, and 44.2% with 3 mismatches. Mean cold ischemia time was 15.45 ± 7.7 hours. Of the recipients, 76% had immediate graft function; 38% experienced 1 acute rejection episode and 4 patients had 2 rejection crises. The initial immunosuppressive regimen was azathioprine (AZA) + prednisolone (Pred) in 14 patients, cyclosporin (CSA) + Pred in 13 patients, and CSA + AZA + Pred in 25 patients. Of these patients, 19% maintained their initial regimen, and 54% (28 patients) were very stable on a mixed CSA regimen for >25 years.
  
  
  RESULTS
  We present the major complications (diabetes, neoplasia, and hepatitis C virus positivity).
  
  
  CONCLUSIONS
  Our results in deceased donor kidney recipients for >25 years are similar to the mixed population (deceased donors and living donors) presented by the Necker group, although 54% of our patients remain on CSA immunosuppression, contradicting the idea that its use is not compatible with good long-term kidney function in transplant recipients.
authors.affiliation: Renal Transplantation Unit, Hospital da Cruz Vermelha Portuguesa, Lisbon, Portugal. Electronic address: fewrnandarego@gmail.com.
authors.forename: F
authors.initials: F
authors.lastname: Rego
authors.affiliation: Renal Transplantation Unit, Hospital da Cruz Vermelha Portuguesa, Lisbon, Portugal.
authors.forename: P
authors.initials: P
authors.lastname: Alçântara
authors.affiliation: Renal Transplantation Unit, Hospital da Cruz Vermelha Portuguesa, Lisbon, Portugal.
authors.forename: F
authors.initials: F
authors.lastname: Buinho
authors.affiliation: Renal Transplantation Unit, Hospital da Cruz Vermelha Portuguesa, Lisbon, Portugal; Nephrology Department, Hospital Santa Maria, Lisbon, Portugal.
authors.forename: A
authors.initials: A
authors.lastname: Gomes da Costa
authors.affiliation: Renal Transplantation Unit, Hospital da Cruz Vermelha Portuguesa, Lisbon, Portugal; Surgery Department, Hospital Curry Cabral, Lisbon, Portugal.
authors.forename: J
authors.initials: J
authors.lastname: Rodrigues Pena
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005544:Forecasting; D006084:Graft Rejection / Q000401:mortality*; D006085:Graft Survival; D006801:Humans; D016030:Kidney Transplantation / Q000401:mortality*; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D010297:Paris / Q000453:epidemiology; D012189:Retrospective Studies; D015996:Survival Rate / Q000639:trends; D066027:Transplant Recipients