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| Predicate | Object |
|---|---|
| rdf:type | |
| lifeskim:mentions | |
| pubmed:dateCreated |
1996-12-10
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| pubmed:abstractText |
Overall one-, 5-, and projected 10-year graft survival rates were 81%, 58% and 39%, respectively for 51,442 cadaveric kidney transplants performed at 251 U.S. transplant centers from October 1987-December 1994. The comparable results for recipients of living donor kidneys were significantly higher, 91%, 75%, and 60% (p<0.001). One-year first cadaver graft survival rates improved from 77% for transplants performed in 1987-1988 to 84% for transplants performed in 1991-1992 (p<0.001). Recipients of second cadaveric transplants in 1987-1988 had a 69% one-year graft survival rate compared with 81% for those transplanted after 1990 (p<0.001). Graft survival rates have been stable since 1991. The percentage of broadly sensitized first transplant recipients decreased from 13% before 1991 to 7% after, and the one-year graft survival rates increased by 4-6% for both sensitized and nonsensitized recipients between the 2 periods (p<0.001). Among retransplanted patients, the percent of broadly sensitized recipients fell from 40-33% over the same periods (p<0.01). One-year graft survival rates increased by 7-8% for sensitized and nonsensitized patients (p<0.001). One-year graft survival rates improved from 74-83% for Blacks (p<0.001) and from 78-85% for non-Blacks (p<0.001) transplanted for the first time when comparing transplants performed in 1987-88 with those performed in 1993-94. The cause of donor death had a significant effect on graft survival. The 5-year graft survival rate was 61% for 28,923 recipients of trauma donor kidneys compared with 54% for 16,956 transplants from CVA donors (p<0.001). Kidneys from CVA donors increased from 28% of all cadaveric kidneys in 1988 to 38% in 1994. The donor's age was a more important determinant of long-term survival, however, and correlated strongly with the cause of donor death. Only 16% of CVA donors were reportedly age 30 or less, compared with 75% of trauma donors. First cadaver graft survival decreased by approximately 2% for each 12 hours of cold ischemia time. Although there was a significant increase in the incidence of delayed graft function from 19% when the CIT was less than 12 hours to 35% when the CIT was more than 36 hours, there was no significant long-term effect of cold ischemia time. The recent change in UNOS policy to share zero-HLA mismatched kidneys resulted in a 2-fold increase (from 8%-16%) in the number of HLA-matched transplants performed during the first 6 months following the change. The percentage of Blacks who have received matched kidneys following this change has increased from less than 2% to more than 5%, a 3-fold increase. The 163 Blacks who received an HLA-matched kidney prior to 1995 had a 65% 4-year graft survival rate compared with 53% for mismatched Blacks (p<0.001). The incidence of early rejections was also reduced by 25% among matched recipients and the graft half-life was 8 years compared with 5 years for mismatched Blacks. About 25% of HLA-matched kidneys were transplanted to ABO compatible but not identical recipients. Although the effect of the policy allowing compatible transplants did not result in a large number of type O kidneys transplanted to non-O recipients when only 8% of kidneys were shared, the recent change in allocation policy may be detrimental to type O waiting patients.
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| pubmed:language |
eng
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| pubmed:journal | |
| pubmed:citationSubset |
IM
|
| pubmed:chemical | |
| pubmed:status |
MEDLINE
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| pubmed:issn |
0890-9016
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| pubmed:author | |
| pubmed:issnType |
Print
|
| pubmed:owner |
NLM
|
| pubmed:authorsComplete |
Y
|
| pubmed:pagination |
1-18
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| pubmed:dateRevised |
2004-11-17
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| pubmed:meshHeading |
pubmed-meshheading:8794251-Adolescent,
pubmed-meshheading:8794251-Adult,
pubmed-meshheading:8794251-Age Factors,
pubmed-meshheading:8794251-Cadaver,
pubmed-meshheading:8794251-Cause of Death,
pubmed-meshheading:8794251-Child,
pubmed-meshheading:8794251-Child, Preschool,
pubmed-meshheading:8794251-Graft Survival,
pubmed-meshheading:8794251-HLA Antigens,
pubmed-meshheading:8794251-Humans,
pubmed-meshheading:8794251-Infant,
pubmed-meshheading:8794251-Kidney Transplantation,
pubmed-meshheading:8794251-Living Donors,
pubmed-meshheading:8794251-Middle Aged,
pubmed-meshheading:8794251-Organ Preservation,
pubmed-meshheading:8794251-Registries,
pubmed-meshheading:8794251-Reoperation,
pubmed-meshheading:8794251-Survival Rate,
pubmed-meshheading:8794251-Tissue Donors,
pubmed-meshheading:8794251-Tissue and Organ Procurement,
pubmed-meshheading:8794251-United States
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| pubmed:year |
1995
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| pubmed:articleTitle |
The UNOS scientific renal transplant registry. United Network for Organ Sharing.
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| pubmed:affiliation |
UCLA Tissue Typing Laboratory, Los Angeles, California, USA.
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| pubmed:publicationType |
Journal Article
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