Kidney transplantation at UCLA.

1. Six hundred twenty kidney transplants have been performed at UCLA since 1984. Rather than 1 rigid immune suppression protocol for all patients, an individualized approach has been taken since the advent of OKT3 in 1987. Since then, the 1-year cadaver graft and patient survival rates have been 87% and 97%, respectively, for both primary and repeat transplants, including various categories of high-risk recipients. 2. Delayed graft function, HLA matching, and percent prior sensitization were major determinants of graft survival. Race, age, and diabetes were not significant determinants of graft outcome. 3. Small children had a 94% 1-year graft survival rate following cadaver transplantation. Sequential immune suppression, the use of large kidneys, and careful perioperative fluid management to prevent graft thrombosis may be responsible for the graft survival rate. 4. Long-term (1 year) results continue to show deterioration in graft survival. Many patients are hypertensive and hypercholesterolemic. Many children are noncompliant with medications.