Results of renal transplantation five to twenty-six years after surgery, using azathioprine and low-dose prednisolone as sole immunosuppression.

This paper describes the results of renal transplantation carried out in a single center from 10-26 years ago. Three hundred and eighty-six recipients received 440 grafts, 400 were cadaver grafts and 40 were from living donors, including one unrelated donor whose kidney was removed during an operation. All patients received immunosuppression with azathioprine and low-dose steroid. 1. Over the whole period, 1968-1986, 46% patients remain alive. The actual total patient survival was 65% for 1986 transplants, 51.7% for 1981 transplants, 37.1% for 1976 transplants and 31.2% for those transplanted 25 years ago. 2. Actual overall graft survival is 39.5% for the whole period. 3. Fifty-seven percent of living-related donor grafts survived over the whole period, including 48% of parental grafts and 69% of sibling grafts. 4. Ten years after transplantation, 54.2% of grafts carried out in 1986 are functioning, as are 40% of those transplanted in 1981, and 29% of those done in 1976 or before. In all 37% of first cadaver grafts continue to function, while 62% have failed. However 35 patients died with a well-functioning graft, due to either cardiovascular disease or neoplasia in 91% of cases. 5. Thirty-four percent of second cadaver grafts function over the whole period, 65.8% have failed. Only one of 9 third cadaver grafts, dating from 1975, continues to function.