Clinical analysis of 206 cases of kidney transplantation

From July 1981 to May 1991, 206 kidney transplantations were performed at the Chang Gung Memorial Hospital. There were 762 patients on our waiting list for transplantation at that time. Patient follow-up care was undertaken, alternately, by urologists and nephrologists. The average follow-up period was 4.0 +/- 2.8 years. Patient data were registered in the UCLA (University of California at Los Angeles) International Kidney Transplant Registry. Eighty patients received living-related transplants, 126 received cadaveric transplants. Twenty-four per cent of transplant recipients were carriers of HBsAg. Their survival rates were equal to those of non-carriers up to five years postoperatively, although they were prone to episodes of hepatitis. Nineteen kidneys were from HBsAg carriers with recipient survival rates, five years postoperatively, not significantly different from those who received kidneys from non-carriers. However, there was one case of seroconversion from HBsAg negative to HBsAg positive status. There were 19 deaths among the recipients, the major cause of death being infection (57.9%). Eight grafts were lost due to medical noncompliance. Malignant lymphomas were noted in three cases who are now alive and well. Three cases of hepatomas were noted, but unfortunately none of them survived. The transplant recipients were found to enjoy a better quality of life after undergoing psychiatric evaluation. The one-year patient survival rate was 97.4% and 96.2% for living-related and cadaveric transplants, respectively. The one-year graft survival rate was 96.0% and 88.5% for living-related and cadaveric transplants, respectively. Kidney transplantation is a well-accepted method of treatment for end-stage renal disease.