Purpose: The number of potential renal transplant recipients far exceeds the number of cadaveric donors. For this reason, living-related donors (LRD) and living-unrelated donors (LURD) have been used to decrease the cadaveric donor shortage. We analyzed 571 living donor transplants for 25 years in our center.
Methods: From 1978 to 2003, 571 patients underwent LRD (n=253) or LURD (n=318) kidney transplantation. The patients were divided into precyclosporin era (1978~1987, n=43, era I), cyclosporin era (1988~1997, n=368, era II), and cyclosporin plus mycophenolate- mofetil era (1998~2003, n=160, era III). We compared the graft survival rate of the recipients according to the immunosuppressants and analyzed the variables such as donor’s and recipient’s age, sex, HLA matching and acute rejection rate. We also compared the long-term survival rate between LRD and LURD.
Results: 1 and 10-year graft survival rates of all patients were 94.3% and 75.5%, respectively. 1 and 10-year graft survival rates were 74.4% and 36.2% in era I, 94.3 % and 78.4% in era II. 1 and 5-year graft survival rates were 96.7% and 90.5% in era III (P<0.001). The occurrence rate of acute rejection was 23.3% (era I), 22.3% (era II), and 14.3% (era III) (P=0.000). 1 and 10-year graft survival rates were 92.3% and 81.3% in LRD transplants, and 94.1% and 86.5% in LURD transplants, respectively (P =0.1909).
Conclusion: The graft survival rates of living donor transplants are improving due to advances of patient care and new immunosuppressive agents. We suggest that living donors will be an important source of kidney transplantations.
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