An analysis of predictors of long-term cadaveric renal allograft survival

Clin Transplant. 1995 Aug;9(4):282-8.

Abstract

To determine factors predictive of long-term graft function in patients treated prophylactically with an antilymphocyte antibody, 670 first cadaveric adult renal transplant procedures performed between 1985 and 1991 were reviewed. The actuarial 1- and 5-year patient survival in this group was 95% and 87% respectively, and graft survival was 84% and 70% respectively. The final analysis was based on a study group of 635 patients which excluded 28 patients who lost grafts to early technical failures and 8 patients who were not induced with an antilymphocyte preparation. Multivariate analysis showed that 5-year graft survival was lower in patients with delayed graft function (p = 0.0001), in those who had an acute rejection episode in the first 6 months post-transplant (p = 0.0001), recipients greater than 55 years of age at the time of transplant (p = 0.0001), in patients who were highly sensitized at the time of transplant (p = 0.0331) and, finally, in those who received a graft from an older donor (p = 0.044). The 209 patients with delayed graft function had a 16% lower long-term graft survival than 425 patients with early graft function (62% vs. 78% respectively at 5 years). One or more rejection episodes in the first 6 months post-transplant (329 patients) reduced long-term graft survival by 13% compared to those who did not have a rejection episode (67% vs. 80% respectively at 5 years).(ABSTRACT TRUNCATED AT 250 WORDS)

MeSH terms

  • Actuarial Analysis
  • Acute Disease
  • Adolescent
  • Adult
  • Age Factors
  • Aged
  • Antilymphocyte Serum / therapeutic use
  • Cadaver
  • Creatinine / blood
  • Female
  • Follow-Up Studies
  • Forecasting
  • Graft Rejection / epidemiology
  • Graft Survival*
  • Humans
  • Immunization
  • Immunosuppressive Agents / therapeutic use
  • Kidney Transplantation / pathology
  • Kidney Transplantation / physiology
  • Kidney Transplantation / statistics & numerical data*
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Ontario / epidemiology
  • Risk Factors
  • Survival Analysis
  • Transplantation Immunology
  • Transplantation, Homologous

Substances

  • Antilymphocyte Serum
  • Immunosuppressive Agents
  • Creatinine