The UNOS Scientific Renal Transplant Registry
- PMID: 9286555
The UNOS Scientific Renal Transplant Registry
Abstract
1. One-year graft survival rates for recipients of cadaver kidney transplants improved from 75% in 1988 to 83% in 1991 (p < 0.001). The one-, 5-, and projected 10-year graft survival rates for cadaver donor transplants performed in 1991-1995 were 84%, 60%, and 43% respectively. 2. One-year graft survival rates for recipients of living donor transplants also improved from 89% in 1988 to 93% in 1991 (p < 0.001). The one-, 5-, and projected 10-year graft survival rates for living donor kidney transplants performed in 1991-1995 were 92%, 75%, and 62% respectively. 3. Diabetic patients received one-quarter of the cadaver kidneys transplanted from 1991-1995 and one third of diabetic patients received a simultaneous pancreas (SPK) transplant. One- and 5-year graft survival rates were 81% and 54% for diabetics receiving a kidney transplant and 85% and 67% for SPK recipients, respectively. Patient survival was 10% lower for recipients of a kidney only transplant. 4. Sensitization to alloantigens, whether by pregnancy, transfusion, or graft failure resulted in about a 5% increased risk of early graft failure. Patients who developed broadly reactive anti-HLA antibodies before their first transplant had the same 5-year graft survival rate (60%) as unsensitized patients. Retransplanted patients who had not developed broadly reactive antibodies also had a 60% 5-year graft survival rate, compared with 50% for those with > 50% PRA. 5. Blacks received one-quarter of cadaver kidneys transplanted in 1991-1995. The one-year graft survival rate for Black first transplant recipients was 83% compared with 84% for Whites. After the first year, the graft loss rate among Blacks was almost double that for other racial groups (5.8 year half-life vs 11.3 years for Whites, p < 0.01). The 5-year graft survival rate was 49% among Blacks and 63% for Whites. Asian recipients had the highest one- and 5-year graft survival rates (89% and 70%, respectively). 6. Shared kidneys had a longer average cold ischemia time (30 hr) than kidneys transplanted locally (21 hr). Fewer than half of shared kidneys were transplanted to HLA-matched recipients. The 5-year graft survival rate for shared kidneys with zero or one HLA antigen mismatched was 68% compared with 59% for shared kidneys with more than 3 antigens mismatched and for locally transplanted kidneys (p < 0.001). 7. The distribution of living donor relationships has changed substantially. When comparing transplants performed in 1988-1989 with those performed in 1994-1995, the number of living donor transplants increased by 80%, the fraction of offspring-to-parent grafts increased from 9-15%, the fraction of genetically unrelated donors increased from 4-10%, and the fraction of distant relatives increased from 2-6% of the living donor transplants. 8. The results of living donor transplants generally followed the degree of HLA compatibility. The one-year survival rate for HLA-identical sibling grafts was 96%, followed by 92% for one-haplotype matched sibling, parent and offspring donor transplants, 90% for unmatched sibling donors and 88% for spousal donors. Other unrelated donor transplants had a slightly higher one-year graft survival rate of 92%, which was more similar to the one-haplotype matched grafts.
Similar articles
-
The UNOS Scientific Renal Transplant Registry.Clin Transpl. 1998:1-16. Clin Transpl. 1998. PMID: 10503082
-
The UNOS Scientific Renal Transplant Registry--ten years of kidney transplants.Clin Transpl. 1997:1-14. Clin Transpl. 1997. PMID: 9919387
-
The UNOS scientific renal transplant registry. United Network for Organ Sharing.Clin Transpl. 1995:1-18. Clin Transpl. 1995. PMID: 8794251
-
Lessons learned from more than 1,000 pancreas transplants at a single institution.Ann Surg. 2001 Apr;233(4):463-501. doi: 10.1097/00000658-200104000-00003. Ann Surg. 2001. PMID: 11303130 Free PMC article. Review.
-
Clinical transplants 1988. Overview.Clin Transpl. 1988:409-34. Clin Transpl. 1988. PMID: 3154492 Review.
Cited by
-
Unraveling the Role of Allo-Antibodies and Transplant Injury.Front Immunol. 2016 Oct 21;7:432. doi: 10.3389/fimmu.2016.00432. eCollection 2016. Front Immunol. 2016. PMID: 27818660 Free PMC article. Review.
-
Alloprimed CD8(+) T cells regulate alloantibody and eliminate alloprimed B cells through perforin- and FasL-dependent mechanisms.Am J Transplant. 2014 Feb;14(2):295-304. doi: 10.1111/ajt.12565. Am J Transplant. 2014. PMID: 24472191 Free PMC article.
-
Consideration of donor age and human leukocyte antigen matching in the setting of multiple potential living kidney donors.Transplantation. 2011 Jul 15;92(1):70-5. doi: 10.1097/TP.0b013e31821cded7. Transplantation. 2011. PMID: 21659945 Free PMC article.
-
Simultaneous pancreas-kidney transplantation and living related donor renal transplantation in patients with diabetes: is there a difference in survival?Ann Surg. 2000 Mar;231(3):417-23. doi: 10.1097/00000658-200003000-00015. Ann Surg. 2000. PMID: 10714635 Free PMC article.
-
Decreased acute rejection in kidney transplant recipients is associated with decreased chronic rejection.Ann Surg. 1999 Oct;230(4):493-8; discussion 498-500. doi: 10.1097/00000658-199910000-00005. Ann Surg. 1999. PMID: 10522719 Free PMC article.
Publication types
MeSH terms
LinkOut - more resources
Medical
Research Materials