Results of 250 consecutive cadaver kidney transplants.

Abstract

SummaryThe results of 250 cadaver kidney transplants performed at this hospital between May 1968 and December 1974 were analysed. A functioning transplant was defined strictly as one that maintained the recipient in good health with a serum creatinine below 442 pmol/l (5 mg/ 100 ml) without any need for dialysis. The proportions of kidneys functioning after one, two, and three years were 40 40, 33.9%, and 31 1% respectively, the corresponding survival rates of patients being 62 6%, 57*40°, and 43-8%.The primary failure rate overall was 216/o, while the failure rates for first, second, and third transplants were 18l1%, 3999%, and 66 70o respectively. Half of the primary failures were attributed to the use of cadaver kidneys with abnormal vasculature or long ischaemic times or originating from non-ventilated donors. Of the initially successful transplants 49%o were subsequently lost due to rejection (53°h) or death of the patient with a functioning transplant (46%), and of the secondary losses 58% occurred within three months of transplantation. HLA matching of donor and recipient for two or more antigens was associated with a significant increase in transplant survival-460' at three years as opposed to 9 5% at three years for kidneys with poorer matches.

Renal autotransplantation in the treatment of hypertension and uraemia due to renal artery stenosis

“…Marx experienced urological complications in only 3.5 per cent of patients (Man et al, 1974), although in a collective review of the experience of several centres this type of complication was reported in 14 per cent of renal transplant recipients (Weil et al, 1971). Renal artery occlusion has been reported after up to 8 per cent of allografts (Hall et al, 1976), but usually occurs in kidneys which are ischaemic and non-viable from the outset and should not be a problem in autotransplantation. Since urological complications are thought to be due, at least in part, to ureteral rejection and to immunosuppressive therapy, they too should be less frequent with autotransplants.…”