0

The full content of Annals is available to subscribers

Subscribe/Learn More  >
Articles |

Kidney Transplantation from Living Unrelated Donors

Ricardo Sesso, MD, MSc; Michael J. Klag, MD, MPH; Meide S. Ancao, MD; Paul K. Whelton, MD, MSc; Alexander Seidler, PhD; Daniel Sigulem, MD; and Oswaldo L. Ramos, MD
[+] Article and Author Information

Grant Support: By a grant from the Rockefeller Foundation (International Clinical Epidemiology Network), Conselho Nacional de Desenvolvimento Cientifico e Tecnologico (CNPq, Brazil), and from the Institute Paulista de Estudos e Pesquisas em Nefrologia e Hipertensao, Brazil. Dr. Sesso is a recipient of a postdoctoral fellowship grant from the Conselho Nacional de Desenvolvimento Cientifico e Tecnologico (CNPq, Brazil). Dr. Klag is an established investigator of the American Heart Association.

Requests for Reprints: Ricardo Sesso, MD, Escola Paulista de Medicina, Division of Nephrology, Rua Botucatu 740, Sao Paulo, SP, 04023, Brazil.

Current Author Addresses: Drs. Sesso and Ramos: Division of Nephrology, Escola Paulista de Medicina, Rua Botucatu 740, Sao Paulo, SP, 04023, Brazil.

Drs. Klag, Whelton, and Seidler: The Johns Hopkins Health Institutions, 600 North Wolfe St., Carnegie 292, Baltimore, Maryland, 21287.

Drs. Ancao and Sigulem: Health Informatics Center, Escola Paulista de Medicina, Rua Botucatu 740, Sao Paulo, SP, 04023, Brazil.


© 1992 American College of PhysiciansAmerican College of Physicians


Ann Intern Med. 1992;117(12):983-989. doi:10.7326/0003-4819-117-12-983
Text Size: A A A

Objective: To compare patient and graft survival of recipients of kidneys from living, unrelated donors (LUDs); cadaveric donors; and living, related donors (LRDs) matched for zero (mismatched), one, or two (identical) haplotypes.

Design: Cohort study.

Setting: Sixty-three renal transplantation centers affiliatedfiliated with the Brazilian Transplantation Registry (accounting for more than 95% of the transplantation activity in Brazil).

Patients: Patients having renal transplantation between January 1987 and March 1991. Of 2892 patients, 165 (6%) received transplants from LUDs; 964 (33%), from cadaveric donors; 183 (6%), from zero haplotype, HLA-matched LRDs; 1259 (44%), from one haplotypematched LRDs; and 321 (11%), from two haplotype-matched LRDs.

Measurements: Patient and graft survival. Patients were followed for an average of 15.8 months.

Results: After adjustment for age, race, diagnosis of primary disease, history of previous transplantation, cyclosporine use, and number of transplants from LUDs per center, patient survival did not differ statistically for recipients of kidneys from LUDs and recipients of cadaveric kidneys (risk ratio [RR], 1.16; 95% CI, 0.68 to 1.98). Little difference was seen between the adjusted death rate for recipients of zero haplotype-matched LRDs and recipients of cadaveric kidneys (RR, 1.13; CI, 0.69 to 1.87). Similarly, in a multivariate analysis, recipients of kidneys taken from LUDs and zero haplotype-matched LRDs had a risk for graft failure that did not differ statistically from that of cadaveric kidney recipients (RR, 0.74; CI, 0.45 to 1.22 and RR, 0.82; CI, 0.53 to 1.25, respectively).

Conclusions: Graft survival for recipients of kidneys from LUDs is similar to that from zero haplotype-matched LRDs and is at least as good as that achieved with cadaveric transplants.

Figures

Tables

References

Letters

NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Comments

Submit a Comment
Submit a Comment

Summary for Patients

Clinical Slide Sets

Terms of Use

The In the Clinic® slide sets are owned and copyrighted by the American College of Physicians (ACP). All text, graphics, trademarks, and other intellectual property incorporated into the slide sets remain the sole and exclusive property of the ACP. The slide sets may be used only by the person who downloads or purchases them and only for the purpose of presenting them during not-for-profit educational activities. Users may incorporate the entire slide set or selected individual slides into their own teaching presentations but may not alter the content of the slides in any way or remove the ACP copyright notice. Users may make print copies for use as hand-outs for the audience the user is personally addressing but may not otherwise reproduce or distribute the slides by any means or media, including but not limited to sending them as e-mail attachments, posting them on Internet or Intranet sites, publishing them in meeting proceedings, or making them available for sale or distribution in any unauthorized form, without the express written permission of the ACP. Unauthorized use of the In the Clinic slide sets will constitute copyright infringement.

Toolkit

Buy Now

to gain full access to the content and tools.

Want to Subscribe?

Learn more about subscription options

Advertisement
Related Articles
Journal Club
Related Point of Care
Topic Collections
PubMed Articles
Antiretroviral therapy and the kidney. Top Antivir Med 2014 June/July;22(3):655-658.
Forgot your password?
Enter your username and email address. We'll send you a reminder to the email address on record.
(Required)
(Required)