PROGRESS IN RENAL-TRANSPLANTATION - A SINGLE-CENTER STUDY OF 3359 PATIENTS OVER 25 YEARS

被引：47

作者：

DIETHELM, AG ^{[1
]}

DEIERHOI, MH ^{[1
]}

HUDSON, SL ^{[1
]}

LASKOW, DA ^{[1
]}

JULIAN, BA ^{[1
]}

GASTON, RS ^{[1
]}

BYNON, JS ^{[1
]}

CURTIS, JJ ^{[1
]}

机构：

[1] UNIV ALABAMA,SCH MED,DEPT MED,BIRMINGHAM,AL 35294

来源：

ANNALS OF SURGERY | 1995年 / 221卷 / 05期

关键词：

D O I：

10.1097/00000658-199505000-00002

中图分类号：

R61 [外科手术学];

学科分类号：

摘要：

Objective The study analyzed 3359 consecutive renal transplant operations for patient and graft survival, including living related, cadaveric, and living unrelated patients. The analysis was separated into three groups according to immunosuppression and date of transplant. Summary Background Data Improvements in renal transplantation in the past 25 years have been the result of better immunosuppression, organ preservation, and patient selection. Methods A single transplant center's experience over a 25-year period was analyzed regarding patient and graft survival. Potential risk factors included patient demographics, tissue typing, donor characteristics, number of transplants, acute and chronic rejection, acute tubular necrosis, primary disease, and malignancy. Results The primary cause of graft loss was rejection. Improvement in cadaveric graft survival since 1987 with quadruple therapy was not apparent in living donor patients. Race continued to be a negative factor in graft survival. Avoiding previous mismatched antigens and the use of flow cytometry improved allograft survival. The leading cause of death in the past 7 years in cadaveric recipients was cardiac (52%). Conclusions Improved graft survival in the past 25 years was related to 1) advances in immunosuppression, 2) better methods of cytotoxic antibody detection, and 3) human lymphocyte antigen match.

引用

页码：446 / 458

页数：13

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