A single center experience with cyclosporine in renal transplantation: Ohio State University 1983 to 1987

Abstract

1. Equivalent graft survival for both diabetic and nondiabetic recipients can be accomplished in haploidentical living-related donor transplants with either DST and posttransplant conventional immunosuppression or a CsA-prednisone protocol without pretransplant DST. 2. There is an 8% difference in one-year graft survival between living-related (91%) and first cadaveric (83%) donor renal transplants. At 2 years this difference is 12%. 3. In primary cadaveric donor transplants, only diabetic status and immediate graft nonfunction (ATN) proved significant determinants of graft survival. The degree of HLA-A, B, or DR match, transfusion, recipient age, or level of presensitization, were all variables that did not significantly correlate with outcome. 4. In the retransplanted population the level of presensitization and the presence of immediate graft nonfunction (ATN) proved significant variables on univariant analysis. The relationship between recipient presensitization as reflected in PRA and the incidence of ATN and the interplay of these 2 variables on graft survival strongly suggest an immunologically unique environment in the recipient undergoing retransplantation that negatively impacts on graft survival and that is not present following presensitization of primary cadaveric recipients.