5,000 kidney transplants--a single-center experience.

A. Moss, J. S. Najarian, D. E. Sutherland, W. D. Payne, Rainer W G Gruessner, A. Humar, R. Kandaswamy, K. J. Gillingham, D. L. Dunn, A. J. Matas

Research output: Contribution to journalArticle

18 Citations (Scopus)

Abstract

Between 6/1963 and 12/1998, 5,069 kidney transplants were done at the University of Minnesota. Of these, about half have been living donor, half cadaver. The majority (83%) have been primary transplants. Recipients were grouped in 6 eras based on changes in our immunosuppressive protocols--6/63-12/67 (n = 98); 1/68-7/79 (n = 1,188); 8/79-6/84 (n = 789); 7/84-9/90 (n = 1,006); 10/90-12/95 (n = 1,050; 1/96-12/98 (n = 718)--and their outcomes were compared. Recent eras contained a higher proportion of recipients aged > 50. Since the inception of the program, there has been a steady improvement in actuarial patient survival, graft survival, and death-censored graft survival. Short-term outcome for primary and retransplant recipients has been similar; however, long-term outcome seems worse for retransplant recipients. Importantly, acute rejection and infectious death have become rare causes of graft loss. Chronic rejection and death with function (most often due to a cardiovascular event) have become the predominant causes of graft loss. Recent changes in immunosuppressive protocols (Era VI) have included more aggressive attempts to maintain CsA levels > 150 ng/ml (by HPLC) in the first 3 months and the substitution of mycophenolate mofetil for azathioprine. As a result, the incidence of acute and chronic rejection has decreased and graft survival has improved.

Original languageEnglish (US)
Pages (from-to)159-171
Number of pages13
JournalClinical transplants
StatePublished - 2000
Externally publishedYes

Fingerprint

Graft Survival
Transplants
Kidney
Immunosuppressive Agents
Mycophenolic Acid
Living Donors
Azathioprine
Cadaver
High Pressure Liquid Chromatography
Survival
Incidence

Cite this

Moss, A., Najarian, J. S., Sutherland, D. E., Payne, W. D., Gruessner, R. W. G., Humar, A., ... Matas, A. J. (2000). 5,000 kidney transplants--a single-center experience. Clinical transplants, 159-171.

5,000 kidney transplants--a single-center experience. / Moss, A.; Najarian, J. S.; Sutherland, D. E.; Payne, W. D.; Gruessner, Rainer W G; Humar, A.; Kandaswamy, R.; Gillingham, K. J.; Dunn, D. L.; Matas, A. J.

In: Clinical transplants, 2000, p. 159-171.

Research output: Contribution to journalArticle

Moss, A, Najarian, JS, Sutherland, DE, Payne, WD, Gruessner, RWG, Humar, A, Kandaswamy, R, Gillingham, KJ, Dunn, DL & Matas, AJ 2000, '5,000 kidney transplants--a single-center experience.', Clinical transplants, pp. 159-171.
Moss A, Najarian JS, Sutherland DE, Payne WD, Gruessner RWG, Humar A et al. 5,000 kidney transplants--a single-center experience. Clinical transplants. 2000;159-171.
Moss, A. ; Najarian, J. S. ; Sutherland, D. E. ; Payne, W. D. ; Gruessner, Rainer W G ; Humar, A. ; Kandaswamy, R. ; Gillingham, K. J. ; Dunn, D. L. ; Matas, A. J. / 5,000 kidney transplants--a single-center experience. In: Clinical transplants. 2000 ; pp. 159-171.
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