Long-term results of 1047 cadaveric kidney transplantations with special emphasis on initial graft function and rejection
We studied the effect of initial graft function and acute rejection on graft survival in 1047 cadaveric renal transplantations during 1991-1997 with a constant policy of donor selection, graft allocation, and immunosuppression. The overall 1- and 5-year patient survival rates were 96 % and 88 %, and...
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| Veröffentlicht in: | Transplant international 2000, Vol.13 (2), p.122-128, Article 122 |
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| creator | KYLLÖNEN, L. E. J SALMELA, K. T EKLUND, B. H HALME, L. E. H HÖCKERSTEDT, K. A. V ISONIEMI, H. M MÄKISALO, H. J AHONEN, J |
| description | We studied the effect of initial graft function and acute rejection on graft survival in 1047 cadaveric renal transplantations during 1991-1997 with a constant policy of donor selection, graft allocation, and immunosuppression. The overall 1- and 5-year patient survival rates were 96 % and 88 %, and the 1- and 5-year graft survival (GS) rates were 92 % and 78 %. Delayed graft function (DGF) occurred in 31 % and there were 1.2 % never-functioning grafts. One-year GS in transplantations with early graft function (EGF) was 95 % compared to 87 % in DGF (P < 0.001). Donor age and cause of death, type of graft perfusion and cold ischemia time, and type and length of dialysis treatment were significant factors in determining the onset of graft function. These factors did not have a significant direct effect on GS. Early ( < 100 days) acute rejection occurred in 25 %. In transplantations without rejection, the 1 and 5-year GS was 93.3 % and 80.8 %. In acute rejection responding to steroids, the GS was equal to that up to 3 years, but after that a significantly worse survival rate was observed (1- and 5-year GS: 93.6 % and 73.4 %). DGF was detrimental to GS both in transplantations without rejection and in all rejection types. |
| doi_str_mv | 10.1007/s001470050295 |
| format | Article |
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E. J ; SALMELA, K. T ; EKLUND, B. H ; HALME, L. E. H ; HÖCKERSTEDT, K. A. V ; ISONIEMI, H. M ; MÄKISALO, H. J ; AHONEN, J</creator><creatorcontrib>KYLLÖNEN, L. E. J ; SALMELA, K. T ; EKLUND, B. H ; HALME, L. E. H ; HÖCKERSTEDT, K. A. V ; ISONIEMI, H. M ; MÄKISALO, H. J ; AHONEN, J</creatorcontrib><description>We studied the effect of initial graft function and acute rejection on graft survival in 1047 cadaveric renal transplantations during 1991-1997 with a constant policy of donor selection, graft allocation, and immunosuppression. The overall 1- and 5-year patient survival rates were 96 % and 88 %, and the 1- and 5-year graft survival (GS) rates were 92 % and 78 %. Delayed graft function (DGF) occurred in 31 % and there were 1.2 % never-functioning grafts. One-year GS in transplantations with early graft function (EGF) was 95 % compared to 87 % in DGF (P < 0.001). Donor age and cause of death, type of graft perfusion and cold ischemia time, and type and length of dialysis treatment were significant factors in determining the onset of graft function. These factors did not have a significant direct effect on GS. Early ( < 100 days) acute rejection occurred in 25 %. In transplantations without rejection, the 1 and 5-year GS was 93.3 % and 80.8 %. In acute rejection responding to steroids, the GS was equal to that up to 3 years, but after that a significantly worse survival rate was observed (1- and 5-year GS: 93.6 % and 73.4 %). DGF was detrimental to GS both in transplantations without rejection and in all rejection types.</description><identifier>ISSN: 0934-0874</identifier><identifier>EISSN: 1432-2277</identifier><identifier>DOI: 10.1007/s001470050295</identifier><identifier>PMID: 10836648</identifier><language>eng</language><publisher>Oxford: Blackwell Publishing</publisher><subject>Adolescent ; Adult ; Aged ; Biological and medical sciences ; Cadaver ; Child ; Child, Preschool ; Female ; Graft Rejection ; Graft Survival ; Humans ; Infant ; Kidney - physiopathology ; Kidney Transplantation ; Male ; Medical sciences ; Middle Aged ; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases ; Surgery of the urinary system ; Tissue Donors ; Transplantation, Homologous</subject><ispartof>Transplant international, 2000, Vol.13 (2), p.122-128, Article 122</ispartof><rights>2000 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c1968-e5992602d14501929fd91b80e2518d58560b45a94040b2ce839769f37cfcfb0c3</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,4024,27923,27924,27925</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=1366176$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/10836648$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>KYLLÖNEN, L. E. J</creatorcontrib><creatorcontrib>SALMELA, K. T</creatorcontrib><creatorcontrib>EKLUND, B. H</creatorcontrib><creatorcontrib>HALME, L. E. H</creatorcontrib><creatorcontrib>HÖCKERSTEDT, K. A. V</creatorcontrib><creatorcontrib>ISONIEMI, H. M</creatorcontrib><creatorcontrib>MÄKISALO, H. J</creatorcontrib><creatorcontrib>AHONEN, J</creatorcontrib><title>Long-term results of 1047 cadaveric kidney transplantations with special emphasis on initial graft function and rejection</title><title>Transplant international</title><addtitle>Transpl Int</addtitle><description>We studied the effect of initial graft function and acute rejection on graft survival in 1047 cadaveric renal transplantations during 1991-1997 with a constant policy of donor selection, graft allocation, and immunosuppression. The overall 1- and 5-year patient survival rates were 96 % and 88 %, and the 1- and 5-year graft survival (GS) rates were 92 % and 78 %. Delayed graft function (DGF) occurred in 31 % and there were 1.2 % never-functioning grafts. One-year GS in transplantations with early graft function (EGF) was 95 % compared to 87 % in DGF (P < 0.001). Donor age and cause of death, type of graft perfusion and cold ischemia time, and type and length of dialysis treatment were significant factors in determining the onset of graft function. These factors did not have a significant direct effect on GS. Early ( < 100 days) acute rejection occurred in 25 %. In transplantations without rejection, the 1 and 5-year GS was 93.3 % and 80.8 %. In acute rejection responding to steroids, the GS was equal to that up to 3 years, but after that a significantly worse survival rate was observed (1- and 5-year GS: 93.6 % and 73.4 %). DGF was detrimental to GS both in transplantations without rejection and in all rejection types.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Biological and medical sciences</subject><subject>Cadaver</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Female</subject><subject>Graft Rejection</subject><subject>Graft Survival</subject><subject>Humans</subject><subject>Infant</subject><subject>Kidney - physiopathology</subject><subject>Kidney Transplantation</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</subject><subject>Surgery of the urinary system</subject><subject>Tissue Donors</subject><subject>Transplantation, Homologous</subject><issn>0934-0874</issn><issn>1432-2277</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2000</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkU2P1SAUhonRONfRpVvDwrirHigUWJqJH5PcxI2uG0phhrGllUOd3H8v13sTPxLjikCe8745PIQ8Z_CaAag3CMCEApDAjXxAdky0vOFcqYdkB6YVDWglLsgTxDsA4FrCY3LBQLddJ_SOHPZLummKzzPNHrepIF0CZSAUdXa0332Ojn6NY_IHWrJNuE42FVvikpDex3JLcfUu2on6eb21GOt8ojHFcny7yTYUGrbkjgPUprG23Pmft6fkUbAT-mfn85J8ef_u89XHZv_pw_XV233jmOl046UxvAM-MiGBGW7CaNigwXPJ9Ci17GAQ0hoBAgbuvG6N6kxolQsuDODaS_LqlLvm5dvmsfRzROenuodfNuwVY7KrYf8FmdKm5UJVsDmBLi-I2Yd-zXG2-dAz6I9S-j-kVP7FOXgbZj_-Rp8sVODlGbDo7BTqP7uIv7hKMdVVrP2r18WTimomTv9o_wHm-6Qg</recordid><startdate>2000</startdate><enddate>2000</enddate><creator>KYLLÖNEN, L. E. J</creator><creator>SALMELA, K. T</creator><creator>EKLUND, B. H</creator><creator>HALME, L. E. H</creator><creator>HÖCKERSTEDT, K. A. V</creator><creator>ISONIEMI, H. M</creator><creator>MÄKISALO, H. J</creator><creator>AHONEN, J</creator><general>Blackwell Publishing</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>H94</scope><scope>7X8</scope></search><sort><creationdate>2000</creationdate><title>Long-term results of 1047 cadaveric kidney transplantations with special emphasis on initial graft function and rejection</title><author>KYLLÖNEN, L. E. J ; SALMELA, K. T ; EKLUND, B. H ; HALME, L. E. H ; HÖCKERSTEDT, K. A. V ; ISONIEMI, H. M ; MÄKISALO, H. 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Graft diseases</topic><topic>Surgery of the urinary system</topic><topic>Tissue Donors</topic><topic>Transplantation, Homologous</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>KYLLÖNEN, L. E. J</creatorcontrib><creatorcontrib>SALMELA, K. T</creatorcontrib><creatorcontrib>EKLUND, B. H</creatorcontrib><creatorcontrib>HALME, L. E. H</creatorcontrib><creatorcontrib>HÖCKERSTEDT, K. A. V</creatorcontrib><creatorcontrib>ISONIEMI, H. M</creatorcontrib><creatorcontrib>MÄKISALO, H. 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| subjects | Adolescent Adult Aged Biological and medical sciences Cadaver Child Child, Preschool Female Graft Rejection Graft Survival Humans Infant Kidney - physiopathology Kidney Transplantation Male Medical sciences Middle Aged Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases Surgery of the urinary system Tissue Donors Transplantation, Homologous |
| title | Long-term results of 1047 cadaveric kidney transplantations with special emphasis on initial graft function and rejection |
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