[Analysis of 2200 kidney transplantations]

To analyze the clinical results of 2 200 renal transplantations.

The following factors were analyzed: (1) the graft survival rates at 1, 3 and 5 years; (2) main factors contributing to the mortality; (3) factors affecting the survival rate of retransplant grafts; (4) features of cancers after renal transplantation; (5) effect of CSA on liver function after renal transplantation; (6) treatments for chronic rejection; and (7) effect of HLA typing on renal transplantation.

From 1972 to 2000, 2 200 renal transplantations were performed in 1 908 patients (1 337 men and 571 women) with end-stage renal failure in our hospital, Beijing. The graft survival rates at 1, 3 and 5 years were 87.3%, 80.2% and 67.0% respectively, after using CSA since 1985. 302 recipients were aged over 50 years whose one year graft survival rate was 83.4% and one year patient survival rate was 85.4%. Pneumonitis was the dominant death factor after renal transplantation, with an incidence of 4.49% and a death rate of 34.62%. The incidence of positive CMV after renal transplantation was up to 40.3%, in with a death rate of 8.0%. The incidence of tumor after renal transplantation was 1.5%. The most frequent site of tumor was urological system. The patient's liver function before transplantation and the intraindividual variability of bioavailabity to CSA etc. were the major toxic factors of the liver. The incidences of acute rejection were 27%, 35.5%, 22.4%, 20.85%, 0% and 0%, respectively, when the HLA mismatches were 6, 5, 4, 3, 2 and 1.

Using immunosuppressents reasonably, preventing acute rejection, and achieving good HLA typing are the major factors improving long-term graft/patient survival rate.