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

Ann Surg. 1988 May;207(5):538-48. doi: 10.1097/00000658-198805000-00008.

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 survival 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.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Antibodies, Monoclonal / therapeutic use
  • Black People
  • Cadaver
  • Child
  • Female
  • Graft Rejection
  • Graft Survival*
  • HLA Antigens / analysis
  • HLA-B Antigens
  • HLA-DR Antigens / analysis
  • Histocompatibility Testing
  • Humans
  • Immunosuppression Therapy / methods
  • Kidney / immunology
  • Kidney Transplantation*
  • Male
  • Middle Aged
  • Organ Preservation
  • Risk Factors
  • Time Factors
  • Transplantation, Homologous
  • White People

Substances

  • Antibodies, Monoclonal
  • HLA Antigens
  • HLA-B Antigens
  • HLA-DR Antigens