Retrospective evaluation of 2 123 cases of kidney transplantation / 中华外科杂志

ABSTRACT

<p><b>OBJECTIVE</b>To summarize the experiences in kidney transplantation for 23 years.</p><p><b>METHODS</b>From 1978 to 2001, 2123 kidney transplantations were performed for 2012 patients with end stage renal failure. We analyzed the survival rate of patient/kidney at 1-, 3-, 5 years. The possible factors that could influence the transplantation including general data, donor kidney, surgical technique, immunosuppressants, PRA measurement, HLA-antigen matching, complications were also analyzed retrospectively.</p><p><b>RESULTS</b>In 423 cases (1978 to 1990), hyper-acute rejection occurred in 9 (2.1%) and acute rejection in 198 (46.8%). The 1-, 3-, and 5 years patient/graft survival rates were 86.7%/76.3%, 72.5%/67.9% and 69.5%/59.3% respectively. In the 1700 cases (1991 to 2001), acute graft rejection occurred in 252 (14.8%) but no hyper-acute rejection was observed. The 1-, 3-, and 5 year patient/graft survival rates were 98.6%/96.7%, 93.1%/87.3% and 88.1%/83.6% respectively.</p><p><b>CONCLUSIONS</b>Kidney transplantation is a treatment of choice for patients with end-stage renal failure. Well preoperative preparation is the assurance of a successful transplantation; the high quality of donor's kidney is essential to a successful transplant operation. PRA negative and high grade HLA matching can decrease the ratio of early allograft loss and improve patient/kidney survival rate. Combined medication is also important to prevent rejection and decrease drug toxicity. Low-dosage of CsA with MMF and Pred is the ideal regimen of immunosuppressive therapy.</p>