[Retrospective evaluation of 2 123 cases of kidney transplantation]

To summarize the experiences in kidney transplantation for 23 years.

From 1978 to 2001, 2123 kidney transplantations were performed for 2012 patients with end stage renal failure. We analyzed the survival rate of patient/kidney at 1-, 3-, 5 years. The possible factors that could influence the transplantation including general data, donor kidney, surgical technique, immunosuppressants, PRA measurement, HLA-antigen matching, complications were also analyzed retrospectively.

In 423 cases (1978 to 1990), hyper-acute rejection occurred in 9 (2.1%) and acute rejection in 198 (46.8%). The 1-, 3-, and 5 years patient/graft survival rates were 86.7%/76.3%, 72.5%/67.9% and 69.5%/59.3% respectively. In the 1700 cases (1991 to 2001), acute graft rejection occurred in 252 (14.8%) but no hyper-acute rejection was observed. The 1-, 3-, and 5 year patient/graft survival rates were 98.6%/96.7%, 93.1%/87.3% and 88.1%/83.6% respectively.

Kidney transplantation is a treatment of choice for patients with end-stage renal failure. Well preoperative preparation is the assurance of a successful transplantation; the high quality of donor's kidney is essential to a successful transplant operation. PRA negative and high grade HLA matching can decrease the ratio of early allograft loss and improve patient/kidney survival rate. Combined medication is also important to prevent rejection and decrease drug toxicity. Low-dosage of CsA with MMF and Pred is the ideal regimen of immunosuppressive therapy.