Solheim B G, Flatmark A, Halvorsen S, Jervell J, Thorsby E
Scand J Urol Nephrol Suppl. 1980;54:37-40.
During the period 1969 to 1978 survival of recipients of 1st cadaveric renal grafts improved. This improvement occurred in spite of a sharp increase in high risk patients accepted for transplantation, including patients with high age, diabetic nephropathy and advanced arteriosclerotic disease. In the same period 1st graft survival decreased. The declining graft prognosis was related to the acceptance of 3-4 HLA-A and B incompatible grafts from 1973 onwards. Grafts with 0-2 incompatibilities had a stable survival during the whole 10-years period. The group of patients receiving grafts with 3-4 incompatibilities, however, included significantly more patients with diabetic nephropathy and age above 55 years. Further analysis demonstrated that the inferior graft prognosis was caused by a combined effect of HLA-mismatched grafts and the number of high risk patients. The distribution of antibodies at retransplantation (2nd graft) was similar whether the lost 1st graft was compatible for 0-2 or 3-4 HLA antigens. Also the prognosis of retransplantation was similar in the two groups.
1969年至1978年期间，首次尸体肾移植受者的存活率有所提高。尽管接受移植的高危患者数量急剧增加，包括高龄、糖尿病肾病和晚期动脉硬化疾病患者，但存活率仍有所提高。同期，首次移植的肾脏存活率下降。移植预后的下降与1973年起接受3至4个HLA - A和B抗原不相配的移植肾有关。0至2个不相配的移植肾在整个10年期间存活率稳定。然而，接受3至4个不相配移植肾的患者组中，糖尿病肾病患者和55岁以上患者明显更多。进一步分析表明，移植预后较差是由HLA不匹配的移植肾和高危患者数量的综合作用导致的。再次移植（第二次移植）时抗体的分布情况相似，无论丢失的首次移植肾与0至2个还是3至4个HLA抗原相匹配。两组再次移植的预后也相似。
