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Table 6.10. Variables influencing outcome of kidney transplantation

Donor source HLA match PRA level Race

Etiology of renal disease Recipient age

Recipient medical status and body mass index

Expanded criteria cadveric organ donor

Delayed kidney graft function

Prior kidney transplant

Duration of dialysis prior to transplantation

CMV donor/recipient status

Clinical acute rejection

Transplant center effect

United Network for Organ Sharing, and the ESRD networks, sharing datasets and actively working to improve the accuracy of ESRD patient information.

Effect of donor source. The results are defined as patient and graft survival according to the length of time posttransplant. Definition of patient survival is obvious, loss of functional graft survival is defined for patients that have died or have returned to dialysis. Table 6.11 shows the 1-year graft survival rates of cases collected by the SRTR for the year 2000. The results are stratified according to donor source. The outcome of kidney transplantation is superior in recipients receiving a kidney from a living donor. Within this category recipients of sibling HLA-identical grafts do best. Interestingly, there is very little difference among graft survival rates in other living donor categories including 1-haplotype matches, 0-haplotype matches, and living unrelated donors.

Table 6.11. Kidney allograft survival according to donor source

Donor

Cadaver Living

1 Year N

15,850 9,862

3 Years N

15,510 8,265

5 Years N

15,186 7,007

Source: OPTN/SRTR Data as of August 1, 2002. Cohorts are transplants performed during 1999-2000 for 3 month and 1 year; 1997-1998 for 3 year; and 1995-1996 for 5 year survival.

Fig. 6.11. Living donor kidney allograft functional survival according to donor relationship. (Reprinted with permission from: Clinical Transplants 2001, editor Cecka and Terasaki, Publisher UCLA Tissue Typing Laboratory, 2002).
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