Long-term haemodialysis-an enhancing factor for cadaveric graft survival

In 220 consecutive cadaveric kidney transplants, graft survival in patients dialysed for a period of two years or longer was significantly greater than in those dialysed for less than two years. More blood transfusions were received and the formation of HLA antibodies was greater in the group dialysed for more than two years. A positive cross match was the basis for excluding 21% of the HLA positive patients from transplantation during a one year period of observation. When these same HLA positive patients had more than two subsequent opportunities for donor-recipient selection the exclusion rate dropped to 2%. The longer period of dialysis with more blood transfusions had a favourable influence on cadaveric graft survival whereas the formation of HLA antibodies had a negative influence. Even in HLA positive patients graft survival was better in the long-term dialysis group when compared with the group dialysed for a shorter period. These results suggest that longer dialysis with more blood transfusions represents an enhancing factor for cadaveric kidney grafts.