Donor factors.

1. Although left kidneys had a 2% higher graft survival rate at one-year posttransplant, the survival rates for left and right kidneys were comparable at 2, 3, and 4 years after transplantation. Kidneys transplanted en bloc were shown to have a 6% lower graft survival rate than either left or right kidneys. 2. Male donor kidney had a 4% higher rate of graft survival than female donor kidneys at both one and 4 years posttransplant. 3. Kidneys obtained from Black donors had a 4% lower graft survival rate at one-year posttransplant, and a 7% lower graft survival rate at 4 years after transplantation than White donor kidneys. White, Hispanic, and Asian donors all had comparable rates of graft survival at one, 2, and 3 years posttransplant. Black donor kidneys also had a significantly shorter half-life; 6.7 years, compared with 7.1 years for kidneys from Asian donors, 9.7 years for Hispanic donors, and 8.6 years for White donors. Blacks continued to make up a small fragment of the total donor pool, accounting for less than 10% of all cadaveric donor kidneys. 4. Kidneys from type O donors had a 5% higher graft survival rate at 4 years posttransplant when compared to AB kidneys and had a 2% higher 4-year graft survival rate than either type A or B kidneys. 5. Pediatric (younger than 5 years of age) donor kidneys had a 10% lower graft survival rate than kidneys from donors between 6 and 45 years of age. Kidneys from donors over 60 years of age had an 11% lower one-year graft survival rate than donors between 6 and 45 years of age, and a 19% lower survival rate at 4 years posttransplant. Survival rates decreased with increasing donor age; kidneys from donors between 46 and 60 years of age had a 5% lower graft survival rate at one year, and a 9% lower rate of graft survival at 4 years posttransplant when compared to "middle aged" donors. The poorest graft survival was observed for kidneys from donors over 60 years of age; 10% and 19% lower graft survival at one and 4 years posttransplant, respectively, compared to donors between 6 and 45 years of age. 6. Kidneys from trauma donors had a 4% higher survival rate at one-year posttransplant, and a 6% higher survival rate at 4 years posttransplant when compared to kidneys from nontrauma donors. Kidneys obtained from victims of motor vehicle accidents, traumatic suicides, and assaults (gunshot wounds and stabbings) had the highest rate of graft survival.(ABSTRACT TRUNCATED AT 400 WORDS)