Risk Factors for Renal Allograft Outcome in Living Related, and Unrelated Renal Transplantation

Lim, Tae Ho; Kwon, Oh Jung; Kwak, Jin Young; Kang, Chong Myung

Abstract

The lack of available cadaveric organs for transplantation has result in an increased number of kidney transplantation from living donors. In order to characterize correlation of variable factors which affect on the renal graft survival and to compare graft survival of living related donor with that of living unrelated donor, the 515 cases of renal transplantation between January 1979 and December 1997 were reviewed. Each effect of factors included recipient age, donor age, infection, acute rejection, tissue typing, type of donor on graft survival was analyzed as well as the interrelationship on graft survival between six risk factors. It was risk factors which effect on the graft survival that acute rejection, tissue typing and type of donor (P=0.00, P=0.001, P=0.00). The 1 and 5 year graft survival rates of cadaveric renal donor group and acute rejection positive group were 64.8-32.4%, 84.5-49.8% for younger recipient group (<30), 81.3-53.9%, 84.5-49.8% for ideal age group (30-49), 0-0%, 44-44% for older recipients group (>50) (0.017). The 1 and 5 year survival rate of cadaveric renal donor group was 42.8% and 28.6% during 1978-1983, 37.5% and 12.5% during 1984-1990 and 100% and 80% during 1991-1997. The grafts survival rate of unrelated living donor is significantly higher than that of cadaveric grafts during 1978-1990 and had a survival rate similar to that of living related donor grafts under all the circumstance given. The tissue typing, acute rejection and type of donor were significant factor which have influence on the graft survival. The cadaveric renal donor & acute rejection had significantly negative effect in older recipients (>50). Recently, the survival rate of cadaveric graft was remarkably increased, but in the future the more data collection for cadaveric graft is required. Living-unrelated renal transplantation provides comparable result to living-related renal transplantation and the unrelated living donor is excellent source of organs for renal transplant recipients.