Thirty years of kidney transplantation in two Chinese centers

Area of Science:

• Nephrology
• Transplantation Immunology
• Surgical Innovation

Background:

• Kidney transplantation is a vital treatment for end-stage renal disease.
• Over 4,300 renal transplants have been performed at Shanghai No. 1 People's Hospital and Fujian Oriental Hospital since 1976.
• Deceased donors constitute the vast majority (99%) of grafts used.

Purpose of the Study:

• To evaluate long-term graft survival rates in kidney transplantation.
• To identify major causes of graft failure and patient mortality.
• To highlight advancements in transplant procedures, including combined and simultaneous islet-kidney transplants.

Main Methods:

• Retrospective analysis of 4,306 renal transplantation cases.
• Evaluation of graft survival rates using Kaplan-Meier analysis.
• Analysis of causes for graft failure and patient death.

Main Results:

• Graft survival rates for transplants (1995-2004) were 93.9% (1-year), 71.8% (5-year), and 53.9% (10-year).
• Chronic rejection was the primary cause of graft failure (54.3%).
• Graft failure led to 54.2% of patient deaths; 48 combined liver-kidney transplants and one islet-kidney transplant were performed.

Conclusions:

• Modern immunosuppression and HLA-based allocation have improved kidney transplant outcomes.
• Chronic rejection presents a significant obstacle to sustained graft function and patient survival.
• Continued innovation in transplantation, including combined and islet-kidney procedures, offers future therapeutic avenues.