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

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

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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

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ASJC Scopus subject areas

  • Medicine(all)

Cite this

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