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  • Title: Characteristics of recipients whose kidney allograft has functioned for more than 20 years.
    Author: El-Agroudy AE, El-Dahshan KE, Abbass TM, Ismail AM, Shokeir AA, Ghoneim MA.
    Journal: Exp Clin Transplant; 2008 Jun; 6(2):155-60. PubMed ID: 18816244.
    Abstract:
    OBJECTIVES: To study the characteristics of, and predictors for, survival in renal transplant recipients with an allograft functioning for more than 20 years. MATERIALS AND METHODS: Of 144 renal transplants done between 1976 and 1985, 31 allografts were still functioning for more than 20 years (range, 21- 28.5 years). The characteristics of the patients and determinants of the outcomes were obtained by reviewing the patients' medical records. RESULTS: Fourteen patients were treated with cyclosporine, while 17 patients had primary immunosuppression with azathioprine-based regimens. Episodes of acute rejection occurred in 17 patients (58%), 7 of these experienced 2 or more episodes. At most-recent follow-up, the mean serum creatinine level was 132 +/- 44 micromol/L . Four patients were assessed by graft biopsy 15 or more years after the transplant, revealing 2 cases of mild glomerulosclerosis and 2 cases of moderate chronic allograft nephropathy. The most common complication was hypertension (54%). The independent determinants of long-term graft survival were donor age and source, hypertension both before and after renal transplant, and histopathological findings of chronic allograft nephropathy. CONCLUSIONS: Renal transplant offers a near-normal life to patients with end-stage renal disease soon after transplant and for upwards of 20 years and more. We found no significant benefit to cyclosporine-based immunosuppression on long-term graft survival.
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