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5,000 kidney transplants--a single-center experience.
- Source :
-
Clinical transplants [Clin Transpl] 2000, pp. 159-71. - Publication Year :
- 2000
-
Abstract
- Between 6/1963 and 12/1998, 5,069 kidney transplants were done at the University of Minnesota. Of these, about half have been living donor, half cadaver. The majority (83%) have been primary transplants. Recipients were grouped in 6 eras based on changes in our immunosuppressive protocols--6/63-12/67 (n = 98); 1/68-7/79 (n = 1,188); 8/79-6/84 (n = 789); 7/84-9/90 (n = 1,006); 10/90-12/95 (n = 1,050; 1/96-12/98 (n = 718)--and their outcomes were compared. Recent eras contained a higher proportion of recipients aged > 50. Since the inception of the program, there has been a steady improvement in actuarial patient survival, graft survival, and death-censored graft survival. Short-term outcome for primary and retransplant recipients has been similar; however, long-term outcome seems worse for retransplant recipients. Importantly, acute rejection and infectious death have become rare causes of graft loss. Chronic rejection and death with function (most often due to a cardiovascular event) have become the predominant causes of graft loss. Recent changes in immunosuppressive protocols (Era VI) have included more aggressive attempts to maintain CsA levels > 150 ng/ml (by HPLC) in the first 3 months and the substitution of mycophenolate mofetil for azathioprine. As a result, the incidence of acute and chronic rejection has decreased and graft survival has improved.
- Subjects :
- Adolescent
Adult
Cyclosporine therapeutic use
Graft Rejection etiology
Graft Survival
Histocompatibility Testing
Hospitals, University
Humans
Immunosuppressive Agents therapeutic use
Middle Aged
Minnesota epidemiology
Reoperation
Survival Rate
Tissue Donors
Kidney Transplantation immunology
Kidney Transplantation mortality
Kidney Transplantation statistics & numerical data
Subjects
Details
- Language :
- English
- ISSN :
- 0890-9016
- Database :
- MEDLINE
- Journal :
- Clinical transplants
- Publication Type :
- Academic Journal
- Accession number :
- 11512309