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Related Experiment Videos

UCLA and UNOS Registries. Overview.

P I Terasaki, J M Cecka, E Lim

    Clinical Transplants
    |January 1, 1991
    PubMed
    Summary
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    Kidney transplant recipients face a 20% first-year loss rate, primarily due to agonal kidney damage and histocompatibility differences. Early anuria and the need for dialysis significantly reduce graft survival rates.

    Area of Science:

    • Nephrology
    • Transplantation Immunology

    Background:

    • Kidney transplantation is a critical treatment for end-stage renal disease.
    • Understanding early graft loss factors is vital for improving patient outcomes.

    Purpose of the Study:

    • To analyze the causes of early kidney graft loss in transplant recipients.
    • To identify key factors influencing one-year graft survival rates.

    Main Methods:

    • Analysis of data from UCLA and UNOS Registry files for transplant recipients since 1984/1987.
    • Assessment of Human Leukocyte Antigen (HLA) typing quality over time.
    • Correlation of clinical indicators (urine output, dialysis, serum creatinine) with graft survival.

    Main Results:

    • First-year graft loss rate is approximately 20%, attributed to death (3%), technical issues (3%), agonal kidney damage (6%), and histocompatibility differences (7%).

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  • Early anuria, associated with longer cold ischemia time and donor factors, significantly lowers 1-year graft survival by 20 percentage points.
  • Need for dialysis within the first week decreases 1-year graft survival by 15 percentage points; multiple rejections further reduce survival to 57%.

    • Conclusions:

    • Agonal kidney damage and histocompatibility differences are major contributors to early kidney transplant failure.
    • Peri-transplant factors like anuria and dialysis requirements critically impact graft longevity.
    • Serum creatinine levels at discharge serve as a reliable predictor of long-term graft survival.