Cadaver renal transplantation and multivariate analysis for graft survival: a clinical review of 2 016 cases.
- Author:
Jun QI
1
;
Zhilian MIN
;
Youhua ZHU
;
Yushan LIU
;
Jian LU
;
Liming WANG
;
Yawei WANG
;
Jizhong REN
;
Junhua ZHENG
;
Danfeng XU
;
Meisheng ZHOU
;
Yacheng YAO
;
Yi GAO
Author Information
- Publication Type:Journal Article
- MeSH: Adult; Cadaver; Female; Graft Survival; drug effects; Humans; Immunosuppressive Agents; pharmacology; Kidney Transplantation; Male; Multivariate Analysis; Transplantation, Homologous
- From: Chinese Journal of Surgery 2002;40(4):241-247
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVETo review kidney transplantation in the center and analyze the risk factors affecting long-term allograft survival.
METHODSThirty-two relative variables were analyzed with SAS statistical software. Using Log-rank method, we investigated influence of these variables on short-and long-term survival of grafts. Kaplan-Meier analysis was used to estimate the 1-, 3-, 5-, 10-years graft survival rates and half-life. Proportional hazards regression analysis (Cox model) was used to assess and rank the relative risk of potential variables.
RESULTSThe 1-, 3-, 5-, 10-years graft survival rates were 83%, 75%, 66% and 48%. After excluding the patients died with functioning grafts, the 1-, 3-, 5-, 10 years grafts survival rate increased to 89%, 82%, 75% and 69%, respectively. The mean half-life was 8.78 +/- 0.14 and 14.09 +/- 0.20 years, respectively. By Log-rank analysis, factors affecting short- and long-term graft survival were identified as: renal function, duration of graft function became normal, cold-ischemia time, presence of acute rejection, delayed graft function, immunosuppressive regimen, complication, infection, anti-rejection therapy. Cox model multivariate analysis showed that there were 18 factors affecting graft survival.
CONCLUSIONSNew immunosuppressive agents not only significantly increase short-term graft survival, but also have the better long-term outcome tendency. Making assurance to get high quality donor organ and minimizing the death with graft function may be the most feasible way to prolong graft survival at present.