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[Results: of 2000 kidney transplantations]
1Department of Urology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China.
Objective:
To analyze the clinical results of renal transplantations.
Methods:
From 1973 to 1999, 2000 renal transplantations were performed in 1 739 (1 238 males and 501 females) patients with end-stage renal failure. We analyzed the graft survival rates at 1, 3, 5 years; the main factors contributing to the mortality; the factors affecting the survival rate of re-transplant grafts; features of cancers after renal transplantation; the effect of CsA on liver function after renal transplantation; the treatments of chronic rejection; the effect of HLA typing on renal transplantation.
Results:
The graft survival rates at 1, 3, 5 years were 87.33%, 80.17% and 67.04% respectively after using CsA since 1985. 282 recipients were over 50 years. The year graft survival rate was 82.27% and the 1-year patient survival rate was 84.75%. Pneumonitis was the dominant factor of death after renal transplantation, the incidence was 4.49%, and the death rate was 34.62%. The incidence of CMV positive after renal transplantation was 40.30%, and the death rate was 8.03%. Patients should wait a longer period (over 6 months) if the first transplant was failed because of acute rejection. The incidence of tumor after transplantation was 1.46%. The most frequent site of the tumors was urological system. The patient's liver function before transplantation and the intraindividual variability of CsA were the major factors on toxicity of the liver. The incidences of acute rejection were 27%, 35.5%, 22.4%, 20.85%, 0%, 0% respectively when the HLA mismatches were 6, 5, 4, 3, 2 and 1.
Conclusion:
Using immunosuppressants reasonably, preventing acute rejection, achieving good HLA typing are the major factors improving long-term graft/patient survival rate.