Survival Analysis of 1563 Renal Transplants in Brazil: Report of the Brazilian Registry of Renal Transplantation

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Sesso, Ricardo de Castro Cintra [UNIFESP]
Anção, Meide Silva [UNIFESP]
Draibe, Sergio Antonio [UNIFESP]
Sigulem, Daniel [UNIFESP]
Ramos, Oswaldo Luiz [UNIFESP]
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Little is known about renal transplantation activity in developing countries. The objective of this study was to evaluate patient and graft survival among the different types of renal transplant recipients in Brazil. The study population consisted of 1563 patients receiving renal grafts for the first time between 1 October 1987 and 31 December 1989 in 49 transplant centres in Brazil. Data were prospectively collected through individual patient questionnaires. Of the 1563 transplantations performed, 1051 (67%) were from living donors, 467 (30%) from cadaver donors, and 45 (3%) unspecified. A total of 963 (62%) transplants came from living related donors (10% HLA-identical, 45% HLA-haploidentical and 6% HLA-distinct). Among the transplant recipients, only 7% were more than 55 years old, 5% were younger than 15 and 4% had diabetes mellitus. Blacks accounted for 24% of patients receiving transplants. An immunosuppressive regimen, including cyclosporin was used in 75% of cadaver kidney recipients, in 42% of living donor kidney recipients; and in 43% and 75% of HLA-haploidentical and HLA-distinct living related donor recipients, respectively. At 2 years, patient survival for living donor and cadaver donor transplant recipients was 89% and 80% respectively, and graft survival was 76% and 61% respectively. Patient survival for recipients of HLA-identical, haploidentical, and distinct living related donor kidneys was respectively 94%, 90%, and 81% at 2 years, and graft survival was 90%, 75%, and 65% respectively. Graft survival for recipients of HLA-distinct living related donor and non-related donor kidneys compared to cadaver donor kidneys was not significantly different at 2 years (63% vs 61%, P > 0.05). Our data indicate the need for more widespread use of kidneys from cadaver donors for renal transplant patients in Brazil and for more cautious use of living donor kidneys, basing the selection on good HLA compatibility.
Nephrology Dialysis Transplantation. Oxford: Oxford Univ Press United Kingdom, v. 5, n. 11, p. 956-961, 1990.