Long-Term Survival (>25 Years) of Deceased Donor Kidney Transplant Recipients: a Single-Center Experience
| Autor: | J. Rodrigues Pena, F. Buinho, F. Rego, A. Gomes da Costa, P. Alçântara |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2015 |
| Předmět: |
Graft Rejection
Male Adult Paris medicine.medical_specialty medicine.medical_treatment Population Renal function Azathioprine Single Center Internal medicine medicine Kidney Transplantation/mortality Living Donors Humans education Paris/epidemiology Aged Retrospective Studies Transplantation education.field_of_study Survival Rate/trends business.industry Graft Survival Immunosuppression Middle Aged HCC CIR Kidney Transplantation HLA Mismatch Transplant Recipients Surgery Survival Rate Regimen Graft Rejection/mortality Prednisolone Female business medicine.drug Forecasting |
| Zdroj: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) Agência para a Sociedade do Conhecimento (UMIC)-FCT-Sociedade da Informação instacron:RCAAP |
| Popis: | Introduction The aim of this preliminary work is to analyze the clinical features of 52 patients with a functional transplanted kidney for >25 years (all first transplant and all deceased donor recipients) and to compare with a similar though more complete study from Hopital Necker-Paris 2012. Methods The mean graft survival at 25 years is 12.7% and at 30 years is 10%. The actual mean serum creatinine concentration is 1.3 mg/L. We analyzed recipient age (mean, 35.9 years) and gender (29 men and 23 women). Donor age was 26.7 ± 10.3 years. Seven patients (13.4%) were transplanted with 1 HLA mismatch, 42.3% with 2 mismatches, and 44.2% with 3 mismatches. Mean cold ischemia time was 15.45 ± 7.7 hours. Of the recipients, 76% had immediate graft function; 38% experienced 1 acute rejection episode and 4 patients had 2 rejection crises. The initial immunosuppressive regimen was azathioprine (AZA) + prednisolone (Pred) in 14 patients, cyclosporin (CSA) + Pred in 13 patients, and CSA + AZA + Pred in 25 patients. Of these patients, 19% maintained their initial regimen, and 54% (28 patients) were very stable on a mixed CSA regimen for >25 years. Results We present the major complications (diabetes, neoplasia, and hepatitis C virus positivity). Conclusion Our results in deceased donor kidney recipients for >25 years are similar to the mixed population (deceased donors and living donors) presented by the Necker group, although 54% of our patients remain on CSA immunosuppression, contradicting the idea that its use is not compatible with good long-term kidney function in transplant recipients. |
| Databáze: | OpenAIRE |
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