Living-donor renal transplantation in seopf: The impact of histocompatibility, transfusios, and cyclosporine on outcome

Fred Sanfilippo, Leroy Thacker, William K. Vaughn

Research output: Contribution to journalArticle

Abstract

The impact of haplotype match (HM), pretransplant transfusions, and cyclosporine use were examined for living-donor renal transplants performed among 49 centers in the South-Eastern Organ Procurement Foundation (SEOPF) from November 1983 to June 1988 with follow-up through March 1989. During this period, 750 2-HM, 1246 1-HM, and 120 O-HM living-donor transplants were performed at 46, 47, and 27 centers, respectively. Demographic comparisons of the HM categories demonstrated the greatest use of cyclosporine and donor-specific transfusions in the O-HM group, and the greatest use of random blood transfusions (RBT) or no blood transfusions (NBT) in the 2-HM group. By univariate and multivariate (Cox regression) analyses, actuarial graft survival was significantly associated with haplotype match, although excellent 3-year graft survival was seen for O-HM as well as 1-HM and 2-HM first transplant recipients: 74 ± 5%, 80 ± 2%, and 85 ± 2%, respectively. Comparisons were also made among patients receiving DST±CsA, RBTiCsA, and NBT±CsA for each HM group by univariate and mutivariate analyses. For O-HM recipients, DST+CsA was most frequently used and associated with the best long-term survival (86±5% at 3 years) by univariate analysis. For 1-HM recipients, there were no apparent differences in graft survival between DST and RBT groups ± CsA by univariate analysis, but the absence of transfusion (NBT±CsA) was associated with the poorest 3-year survival (79±4%). This was confirmed by multivariate analysis, where DST (P

Original languageEnglish (US)
Pages (from-to)25-29
Number of pages5
JournalTransplantation
Volume49
Issue number1
StatePublished - 1990
Externally publishedYes

ASJC Scopus subject areas

  • Transplantation
  • Immunology

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