Important risk factors of allograft survival in cadaveric renal transplantation. A study of 426 patients

Academic Article

Abstract

  • Multiple risk factors contribute to the allograft survival of patients who have cadaveric renal transplantation. A retrospective review of 19 such factors in 426 patients identified race, DR match, B + DR match, number of transplants, and preservation time to have a significant influence. The parametric analysis confirmed the effect to be primarily in the early phase, i.e., first 6 months. All patients received cyclosporine with other methods of immunosuppression resulting in an overall 1-year graft survival rate of 66%. The overall 1-year graft survival rate in the white race was 73% and in the black race was 57% (p=0.002). Allograft survival and DR match showed white recipients with a 1 DR match to have 75% survival at 1 year compared with 57% in the black patient (p=0.009). If HLA B + DR match was considered, the white recipient allograft survival increased to 76%, 84%, and 88% for 1, 2, and 3 match kidneys by parametric analysis. Patients receiving first grafts had better graft survival (68%) than those undergoing retransplantation (58%) (p=0.05). Organ preservation less than 12 hours influenced allograft survival with a 78% 1-year suvival rate compared with 63% for kidneys with 12-18 hours of preservation. Despite the benefits of B + DR typing, short preservation time, and first transplants to the white recipient, the allograft survival in the black recipient remained uninfluenced by these parameters.
  • Authors

    Published In

  • Annals of Surgery  Journal
  • Digital Object Identifier (doi)

    Author List

  • Diethelm AG; Blackstone EH; Naftel DC; Hudson SL; Barber WH; Deierhoi MH; Barger BO; Curtis JJ; Luke RG
  • Start Page

  • 538
  • End Page

  • 548
  • Volume

  • 207
  • Issue

  • 5