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Living donor renal transplantation is associated with superior graft survival
Last Updated: 2001-03-13 9:33:45 EST (Reuters Health)
WESTPORT, CT (Reuters Health) - In renal transplant patients with end-stage renal disease (ESRD) as a result of focal segmental glomerulosclerosis (FSGS), living donor transplantation is associated with superior graft survival compared with survival after cadaveric transplantation, according to researchers.
Dr. Kevin C. Abbott, of Walter Reed Army Medical Center, Washington, DC, and colleagues conducted a retrospective analysis using data from a national registry of renal transplant recipients to evaluated the frequency and risk factors associated with graft loss in FSGS patients following renal transplantation.
In addition, the researchers determined the affects of living versus cadaveric transplantation, along with donor and recipient race. The analysis, which is reported in the February issue of the American Journal of Kidney Disease, included 3861 patients.
According to the report, recurrent FSGS accounted for 18.7% of all graft loss in living donor recipients and 7.8% in cadaveric recipients. "In white recipients, the corresponding figures were 27% and 13%," the authors note. "Recipient gender was not related to graft loss in univariate analysis."
Dr. Abbott's group found that cadaveric transplant, African-American recipient race, African-American donor race, younger recipient age, total transplants, recipient sensitization, treatment for rejection, and earlier transplant era, were factors significantly associated with graft loss.
Factors associated with graft loss resulting from recurrent FSGS were white recipient, donor African-American kidney in a white recipient, younger recipient age, and treatment for rejection, the investigators explain. "Among renal transplant recipients with FSGS, white recipients had a higher risk of graft loss resulting from recurrent FSGS, disproportionately seen in recipients of African-American kidneys," they write.
The authors suggest that "African-American recipients may have the most to gain from increased rates of living donor transplantation because African-American living donor recipients had improved graft survival compared with African-American cadaveric recipients and lower rates of graft loss resulting from recurrent FSGS than white living donor recipients."
"As progress in reducing graft loss from other causes continues," Dr. Abbott and colleagues conclude, "the issue of recurrent disease will play a progressively larger role in renal transplantation, and dedicated prospective studies of disease recurrence may lead to prevention of FSGS in the renal allograft."
Am J Kidney Dis 2001;37:366-373.
-Westport Newsroom 203 319 2700
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Copyright 2001 Reuters Limited. All rights reserved. Republication or redistribution of Reuters Limited content, including by framing or similar means, is expressly prohibited without prior written consent of Reuters Limited. Reuters Limited shall not be liable for any error or delays in the content, or for any actions taken in reliance thereon.
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