Living donor kidney transplantation in a Veterans Administration medical center.

Kizilisik AT, Ray JM, Nylander WA, Langone AJ, Helderman JH, Shaffer D
Am J Surg. 2004 188 (5): 611-3

PMID: 15546581 · DOI:10.1016/j.amjsurg.2004.07.022

BACKGROUND - A shortage of organ donors remains the major limiting factor in kidney transplantation. Living donor renal transplantation, especially living-unrelated donors, may expand the donor pool by providing another source of excellent grafts.

METHODS - Between 1983 and 2003, 109 living donor kidney transplants were performed. Potential donors were assessed with a standardized routine. Antithymocyte serum (N-ATS) and Basiliximab were used as induction agents. Sandimmune, Gengraf, Neoral, and Prograf were the main immunosuppressants with Immuran, Mycophenolate Mofetil, and steroids. Eighty-two percent of the recipients were from out of state.

RESULTS - Seventy-eight percent of the living donors were from living-related donors and 22% were from living-unrelated donors. One- and three-year patient survival rates were 97.6% and 93.2% with 1- and 3-year graft survival rates of 93.2% and 88.3%, respectively. There were 6 delayed graft functions (5.5%), 16 acute cellular rejections (10%), and 10 chronic rejections (9%). Twelve patients died, 7 of them with a functioning graft. In the past 6 years (1997-2003), the number of living donor kidney transplants surpassed deceased donor kidney transplants.

CONCLUSIONS - Because of the limited number of cadaveric kidneys available for transplant, living donors represent a valuable source, and the use of living-unrelated donors has produced an additional supply of organs. In our program, the proportion of living donors used for kidney transplant is comparable with other non-Veterans Administration programs and the survival of these allografts appears to be superior to deceased donor kidney transplants.

MeSH Terms (15)

Female Follow-Up Studies Graft Rejection Graft Survival Hospitals, Veterans Humans Kidney Transplantation Living Donors Male Postoperative Complications Registries Retrospective Studies Risk Assessment Survival Analysis Treatment Outcome

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