Living donor kidney transplants: Superior success rates despite histoincompatibilities
Living donor kidney transplants: Superior success rates despite histoincompatibilities
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DOI：
10.1016/s0041-1345(96)00063-2
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发表时间：
1997-02-01
影响因子：
0.9
通讯作者：
Terasaki, PI
中科院分区：
文献类型：
--
作者：
Cecka, JM;Terasaki, PI
RESULTSThe l-and 5-year graft survival rates were 90% and 72%‘. respectively, for 2478 recipients of zero-HLA-haplotype matched living donor kidneys. These results were significantly better than the l-and 5-year graft survival rates of 30,862 cadaveric grafts with 4 to 6 HLA antigens mismatched (80% and 57%, respectively, P<, 001) and 24,705 cadaver grafts with 1 to 3 HLA mismatches (83% and 63%. respectively, P<, 001). In fact, the results were comparable to those of 4198 HLA-matched cadaveric transplants (87% and 70%, respectively, P= NS). Although the 41% incidence of rejection episodes during the first 6 months was significantly higher than the 38% reported for 11,246 I-haplotype matched related donor grafts (P<. Ol), l-and5-year graft survival rates were similar. The zero-haplotype matched living donors included 1078 siblings, 745 spouses, 467 other unrelated donors, and 240 distant relatives. No differences in survival were observed among these groups. Among recipients of unrelated donor kidneys, donor-specific transfusions (141 cases) resulted in a significantly improved l-year graft survival rate of 94% compared with 87% in 558 untransfused patients (P=. 02). Random transfusions also improved survival to 91%, but the difference was not significant. Untransfused recipients of unrelated donor grafts had higher l-year graft survival (87%) than cadaver kidney recipients (82%. P<. OOl).
