The impact of immunosuppessive regimens, donor-recipient relationships, recipient's age, blood group ABO compatibility and degree of HLA-matching on the graft survival rate(GSR) were examined from the experience of 700 primary living donor renal
transplants(TLX) perfomed at Yonsei University Medical Center from April, 1979 to August, 1991 with follow-up through February, 1992. Using univariate and multivariate analyses, several risk factors which might affect GSR could be drawn from this
study.
The most important factor is the kind of immunosupprssion (AZA vs CSA, p=0.0003). Using CsA 18.6% of 5-year GSR, benefit can be achieved (67.0 vs 85.6%0. Degree of HLA-matching (identical vs one-haplotype matched) in AZA-treated
recipients(p=0.0008),
ABO compatibility (identical vs compatible) in the CsA-treated group(p=0.366), and also recipient's age(under 50 vs over 51) in the CsA-treated group(p<0.001) were the main risk factors influencing GSR. But, donor-recipient relationship (related
vs
unrelated0, degree of HLA-matching (identical vs one haplotype matched) in the CsA-treated group did not affect GSR. Any degree of HLA Matching is not an important factor for unrelated renal TLX, if at least, HLA-DR 1 antigen matched pains have
to
be
enrolled in the CsA era. These excellent results might reflect the maturation of our experiences and standardization of perioperative care based on protocols.
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