ABSTRACT
Between October 1977 and December 2004, 2,037 kidney transplants were performed in 1,804 patients with ESRD at the Peoples Liberation Army General Hospital Postgraduate Medical School. Overall graft survival rates at one, 5, 10, 15, and 20 years were 91.6%, 79.3%, 64.3%, 53.8%, and 47.6%, respectively. The number of transplants significantly increased during the past decade. One-year patient and graft survival rates have increased from 40% and 35% in the 1970s to 98% and 96% in the 2000s, respectively. Since CSA was introduced to our clinic, one-year graft survival rates have increased from 33% to 93% and the half-lives have significantly improved from 13.1 years to 21.7 years. Also, the graft survival rate for patients on CSA-based triple therapy using MMF was about 18% higher at 5 years than those for patients using AZA (92% vs. 74%, p < 0.001), and 11% higher at 10 years (71% vs. 60%, p < 0.01). Our analysis showed that transplant year, DGF, rejection, immunosuppressive regimen, ABO blood group, and original disease were independent factors impacting on graft survival and poor HLA matching with 5-6 mismatches had an adverse effect on graft survival compared with 1-2 mismatches. Infection, cardio- and cerebral accidents and hepatic failure were the 3 main causes of death in transplant recipients.
