Long-term results of kidney transplantation at the University of Miami.

George W Burke, V. Esquenazi, H. Gharagozloo, David Roth, J. Strauss, G. Kyriakides, M. Milgrom, D. Ranjan, N. Contreras, A. Rosen

Research output: Contribution to journalArticle

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Abstract

Of 631 renal allografts performed at our center between January 1, 1979 and June 30, 1989, 368 were from cadaver donors (CAD) and 263 were from living-related donors (LRD). The recipients were almost equally divided among 3 ethnic groups: Black, Hispanic, and non-Hispanic, non-Black (primarily of northern European background). Recipient ages ranged between 1 and 70 years. In the CAD group HLA matching was emphasized so that no patient received a kidney with less than a 1 DR match, and for the entire series there was a mean of 2.4 of 6 HLA antigens matched between donor and recipient. All patients (LRD and CAD) received at least 3 pretransplant blood transfusions. Overall actuarial 10-year patient and graft survival were 68% and 48% respectively, with 72% patient and 56% graft survival for LRD and 58% patient and 36% graft survival for CAD recipients. Factors adversely affecting long-term graft outcome were: a) Black race. Overall 10-year graft survival was 23% versus 55% for non-Blacks (p = 0.008); b) Type I Diabetes before transplant. Overall 10-year graft survival was 35% versus 51% for nondiabetics; and c) Compliance. This was the most significant factor influencing long-term survival, other than death due to cardiovascular disease. In a non-Black, nondiabetic category of less than 36 years of age at transplantation (n = 169), 10-year patient survival in LRD and CAD groups was 95% and 85%, respectively, and graft survival was 78% and 70%, respectively. This was markedly different from the entire series (p = 0.008). Even in this group, 4 of the 17 graft losses (including mortality) were due to documented prolonged noncompliance in teenagers. The 6 other deaths that occurred were due to hepatitis/cirrhosis (2), CMV (3), and AIDS (1). Among the factors not influencing graft survival in the CAD group was HLA matching after the minimum requirements were fulfilled, either by comparing 1 with 2 DR antigens, or total HLA (1-6) antigens matched.

Original languageEnglish
Pages (from-to)215-228
Number of pages14
JournalClinical transplants
StatePublished - Dec 1 1989

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Graft Survival
Kidney Transplantation
Cadaver
Tissue Donors
Living Donors
Transplants
Kidney
Antigens
Survival
HLA Antigens
Type 1 Diabetes Mellitus
Hispanic Americans
Ethnic Groups
Blood Transfusion
Hepatitis
Compliance
Allografts
Acquired Immunodeficiency Syndrome
Fibrosis
Cardiovascular Diseases

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Burke, G. W., Esquenazi, V., Gharagozloo, H., Roth, D., Strauss, J., Kyriakides, G., ... Rosen, A. (1989). Long-term results of kidney transplantation at the University of Miami. Clinical transplants, 215-228.

Long-term results of kidney transplantation at the University of Miami. / Burke, George W; Esquenazi, V.; Gharagozloo, H.; Roth, David; Strauss, J.; Kyriakides, G.; Milgrom, M.; Ranjan, D.; Contreras, N.; Rosen, A.

In: Clinical transplants, 01.12.1989, p. 215-228.

Research output: Contribution to journalArticle

Burke, GW, Esquenazi, V, Gharagozloo, H, Roth, D, Strauss, J, Kyriakides, G, Milgrom, M, Ranjan, D, Contreras, N & Rosen, A 1989, 'Long-term results of kidney transplantation at the University of Miami.', Clinical transplants, pp. 215-228.
Burke GW, Esquenazi V, Gharagozloo H, Roth D, Strauss J, Kyriakides G et al. Long-term results of kidney transplantation at the University of Miami. Clinical transplants. 1989 Dec 1;215-228.
Burke, George W ; Esquenazi, V. ; Gharagozloo, H. ; Roth, David ; Strauss, J. ; Kyriakides, G. ; Milgrom, M. ; Ranjan, D. ; Contreras, N. ; Rosen, A. / Long-term results of kidney transplantation at the University of Miami. In: Clinical transplants. 1989 ; pp. 215-228.
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