One thousand renal transplants in Belfast (1968-1998)

The first kidney transplant was performed in Belfast in 1968. During the next 30 years 1,000 transplants were undertaken at this unit. Data were analysed on 937 cadaveric transplants, 815 first and 122 regrafts. There were 63 living transplants. Long-term follow-up was achieved for all grafts except one live transplant. All recipients had follow-up of at least 5 years. One- and 5-year graft survival rates were 78.9% and 65.0% for first cadaveric grafts, 83.6% and 66.4% for regrafts and 85.7% and 68.3% for living transplants. Nine of 41 transplants performed more than 30 years ago are still functioning. Multivariate analysis determined risk factors for graft survival as recipient age, donor age, HLA-A mismatching, HLA cytotoxic antibody level and year of transplant. A conservative regime regarding the use of immunosuppression, HLA matching and crossmatching has proved successful in accomplishing good graft survival at this unit.