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| Predicate | Object |
|---|---|
| rdf:type | |
| lifeskim:mentions | |
| pubmed:dateCreated |
1997-10-1
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| pubmed:abstractText |
1. GENERAL: Here we updated our analysis of the UNOS Kidney Registry for the compound effects of 26 transplantation factors on graft survival within 2 consecutive posttransplantation risk periods. During the early risk period, 83,867 kidney-only recipients were followed through one year, and, in the second (chronic) risk period, 66,358 recipients whose grafts survived beyond one year were followed for 5 years after transplantation. 2. SHORT-TERM EFFECTS: From the analysis, the top (< 2% of assignable variation) factors influencing one-year graft survival rates were ranked as follows: 1) living-related and living-unrelated donor transplants were preferred; 2) some transplant centers had outstanding results; 3) kidneys from stroke victims displayed poor results; 4) recipients with PRA > 80% demonstrated poor survival; 5) patients transplanted before 1991 had poor results; 6) increasing numbers of HLA-ABDR mismatches decreased survival; 7) cold ischemia times beyond 24 hours diminished survival; 8) kidneys from younger and older donors impaired survival; 9) regrafting was detrimental, 10) Asians and Hispanics enjoyed superior results; 11) recipients with restricted activities pretransplantation were at higher risk of early graft failure; and 12) high (> 30 kg/m2) body mass recipients demonstrated lowered rates. 3. LONG-TERM EFFECTS: Fewer net factors influenced graft survival beyond 1 year through 5 years. The following 9 factors, each explaining > 2% of the assignable variation in conditional 5-year graft survival, were ranked and yielded poor results: 1) older (> 65) donors; 2) Black recipients; 3) poor transplant centers; 4) male recipients; 5) kidneys from cadaver or living parental donors; 6) transplantation prior to 1991; 7) stroke donors; 8) non-zero HLA-AB mismatched transplants; and 9) teenage recipients. 4. IMPACT ON KIDNEY ALLOCATION: This UNOS data analysis combined with other recent multi-center studies suggest that the criteria for kidney allocation need contain just 2 components in order to maximize long-term survival-an immunologic factor (avoiding HLA mismatches) and a non-immunologic factor (a senior citizens pool to receive older donor organs).
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| pubmed:language |
eng
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| pubmed:journal | |
| pubmed:citationSubset |
IM
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| 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 |
343-60
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| pubmed:dateRevised |
2004-11-17
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| pubmed:meshHeading |
pubmed-meshheading:9286581-Adolescent,
pubmed-meshheading:9286581-Adult,
pubmed-meshheading:9286581-Aged,
pubmed-meshheading:9286581-Cadaver,
pubmed-meshheading:9286581-Child,
pubmed-meshheading:9286581-Child, Preschool,
pubmed-meshheading:9286581-Continental Population Groups,
pubmed-meshheading:9286581-Family,
pubmed-meshheading:9286581-Female,
pubmed-meshheading:9286581-Graft Survival,
pubmed-meshheading:9286581-Humans,
pubmed-meshheading:9286581-Infant,
pubmed-meshheading:9286581-Kidney,
pubmed-meshheading:9286581-Kidney Failure, Chronic,
pubmed-meshheading:9286581-Kidney Transplantation,
pubmed-meshheading:9286581-Living Donors,
pubmed-meshheading:9286581-Male,
pubmed-meshheading:9286581-Middle Aged,
pubmed-meshheading:9286581-Organ Preservation,
pubmed-meshheading:9286581-Pregnancy,
pubmed-meshheading:9286581-Registries,
pubmed-meshheading:9286581-Retrospective Studies,
pubmed-meshheading:9286581-Survival Rate,
pubmed-meshheading:9286581-Time Factors,
pubmed-meshheading:9286581-Tissue Donors,
pubmed-meshheading:9286581-Tissue and Organ Procurement,
pubmed-meshheading:9286581-United States
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| pubmed:year |
1996
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| pubmed:articleTitle |
A multi-factor analysis of kidney graft outcomes at one and five years posttransplantation: 1996 UNOS Update.
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| pubmed:publicationType |
Journal Article
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