CADAVERIC DONOR RENAL TRANSPLANTATION

Although no clear correlation with tissue‐matching has yet appeared, ALG therapy appears beneficial, and together with increasing experience, probably accounts for decreasing numbers of early failures.

Abstract

During the past four years, all suitable patients who presented with end-stage renal failure were treated by dialysis, usually with subsequent cadaveric donor renal transplantation. The major cause for renal failure was glomerulonephritis; other important causes were pyelonephritis and analgesic nephropathy. Two hundred and one patients received renal allografts; 156 (78%) survive, 146 (73%) with functioning grafts, six of which are secondary. The one-year, two-year and three-year survivals for successfully treated patients are 73%, 67% and 65% respectively. Rehabilitation is generally satisfactory. Seventy-four per cent of grafts functioned well from the time of operation and the outcome with these grafts was much improved compared with those with poor early function. Most failures were because of rejection or complications of therapy and occurred within the first few months after operation. Non-function of grafts was rare and, with the exception of one ABO-incompatible graft, hyperacute rejection did not occur. Chronic rejection resulted in failure in only 4% of patients, but in a further 11%, impairment of function is gradually Increasing. Although no clear correlation with tissue-matching has yet appeared, ALG therapy appears beneficial, and together with increasing experience, probably accounts for decreasing numbers of early failures.