Outcome of renal transplantation at Oregon Health Sciences University

1982 to 1990.

Douglas Norman, W. M. Bennett, P. J. Wetzsteon, T. Hefty, M. M. Meyer, D. Tolzman, M. Seely, M. Millhollen, John Barry

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

1. Graft survival increased over the 4 periods between 1982 and 1990 (82-84, 85-86, 87-88, 89-90). The largest increase was in the 89-90 period. 2. Immunosuppression was the key to improved outcome. Cadaveric graft recipients given OKT3 induction plus triple therapy with cyclosporine, azathioprine, and prednisone had significantly better graft survival compared with all other drug combinations. Other factors were improved patient selection, donor management, and outpatient care. 3. Mean serum creatinine levels did not change after cyclosporine was introduced for immunosuppression. The mean serum creatinine level was approximately 1.7 mg/dl at 3 months, 6 months, and 12 months post-transplantation in all 4 periods. 4. Living-related donor outcome was significantly better than cadaveric donor outcome. Half-life for 2-haplotype-matched kidneys was 37 years compared with 12 years for 1-haplotype matches and 6.5 years for cadaveric kidneys. 5. Immediate function and a rejection-free first month were both associated with significantly improved graft survival. 6. Neither peak PRA nor graft number (1st vs regraft) correlated with graft survival. Highly sensitized (PRA greater than 50%) patients and regrafted patients fared as well as less sensitized (PRA less than or equal to 50%) and first graft recipients. This outcome was attributed to a sensitive crossmatch. Because of the crossmatch, highly sensitized patients received much better HLA matches. 7. The incidence of early rejection and delayed function declined significantly between the earliest and latest periods. Improved immunosuppression, donor management, and renal preservation were cited as contributing factors.

Original languageEnglish (US)
Pages (from-to)153-157
Number of pages5
JournalClinical transplants
StatePublished - 1991

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Graft Survival
Kidney Transplantation
Immunosuppression
Health
Tissue Donors
Transplants
Kidney
Haplotypes
Cyclosporine
Creatinine
Muromonab-CD3
Living Donors
Azathioprine
Drug Combinations
Ambulatory Care
Prednisone
Serum
Patient Selection
Half-Life
Transplantation

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Norman, D., Bennett, W. M., Wetzsteon, P. J., Hefty, T., Meyer, M. M., Tolzman, D., ... Barry, J. (1991). Outcome of renal transplantation at Oregon Health Sciences University: 1982 to 1990. Clinical transplants, 153-157.

Outcome of renal transplantation at Oregon Health Sciences University : 1982 to 1990. / Norman, Douglas; Bennett, W. M.; Wetzsteon, P. J.; Hefty, T.; Meyer, M. M.; Tolzman, D.; Seely, M.; Millhollen, M.; Barry, John.

In: Clinical transplants, 1991, p. 153-157.

Research output: Contribution to journalArticle

Norman, D, Bennett, WM, Wetzsteon, PJ, Hefty, T, Meyer, MM, Tolzman, D, Seely, M, Millhollen, M & Barry, J 1991, 'Outcome of renal transplantation at Oregon Health Sciences University: 1982 to 1990.', Clinical transplants, pp. 153-157.
Norman D, Bennett WM, Wetzsteon PJ, Hefty T, Meyer MM, Tolzman D et al. Outcome of renal transplantation at Oregon Health Sciences University: 1982 to 1990. Clinical transplants. 1991;153-157.
Norman, Douglas ; Bennett, W. M. ; Wetzsteon, P. J. ; Hefty, T. ; Meyer, M. M. ; Tolzman, D. ; Seely, M. ; Millhollen, M. ; Barry, John. / Outcome of renal transplantation at Oregon Health Sciences University : 1982 to 1990. In: Clinical transplants. 1991 ; pp. 153-157.
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