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. 1977 Feb;185(2):196–204. doi: 10.1097/00000658-197702000-00011

100 sibling kidney transplants followed 2 to 7 1/2 years: a multifactorial analysis.

R L Simmons, E J Van Hook, E J Yunis, H Noreen, C M Kjellstrand, R M Condie, S M Mauer, T J Buselmeier, J S Najarian
PMCID: PMC1396097  PMID: 319769

Abstract

From January 1, 1968 to May 31, 1973, 100 patients received first kidney transplants from sibling donors. All recipients have been followed for at least two years and several as long as 7.5 years. One hundred per cent follow-up information is available. The absolute two-year patient survival is 85% and the absolute two-year kidney function survival is 76%. Patients with diabetes (especially males) have less success following transplantation than do patients without diabetes. When diabetic patients are excluded, older patients appear to do slightly less well than younger patients. Patients with phenotypically identical HL-A matches with the donor do better than patients without such matches. In the nondiabetic technically perfect transplant recepient, better than 90% long-term transplant function can be expectedwith no kidney losses after the first few months. In contrast, the less well-matched transplant demonstrated both an increased early rejection rate and a high rate of loss after the third to fifth year. Increasing doses of anti-lymphoblast globulin (ALG) had beneficial results in HL-A mismatched sibling transplants, but were slightly detrimental in phenotypically identical HL-A donor-recipient pairs because of an increased rate of infection. The results are compared with the results of transplants from other related donors and from cadavers performed during the same period.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Belzer F. O., Perkins H. A., Fortmann J. L., Kountz S. L., Salvatierra O., Cochrum K. C., Payne R. Is HL-A typing of clinical significance in cadaver renal transplantation? Lancet. 1974 Apr 27;1(7861):774–777. doi: 10.1016/s0140-6736(74)92842-6. [DOI] [PubMed] [Google Scholar]
  2. Callender C. O., Simmons R. L., Yunis E. J., Toledo-Pereyra L. H., DeShazo M. T., Najarian J. S. Anti-HL-A antibodies: Failure to correlate with renal allograft rejection. Surgery. 1974 Oct;76(4):573–580. [PubMed] [Google Scholar]
  3. Delmonico F. L., Cosimi A. B., Russell P. S. Renal transplantation in the older age group. Arch Surg. 1975 Sep;110(9):1107–1109. doi: 10.1001/archsurg.1975.01360150051009. [DOI] [PubMed] [Google Scholar]
  4. Desnick R. J., Simmons R. L., Allen K. Y., Woods J. E., Anderson C. F., Najarian J. S., Krivit W. Correction of enzymatic deficiencies by renal transplantation: Fabry's disease. Surgery. 1972 Aug;72(2):203–211. [PubMed] [Google Scholar]
  5. Diethelm A. G., Aldrete J. S., Shaw J. F., Cobbs C. G., Hartley M. W., Sterling W. A., Morgan J. M. Clinical evaluation of equine antithymocyte globulin in recipients of renal allografts: Analysis of survival, renal function, rejection, histocompatibility, and complications. Ann Surg. 1974 Jul;180(1):20–28. doi: 10.1097/00000658-197407000-00004. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Jonasson O., Lichter E. A., Hamby W. M., Smith R. D., Gantt C. L., Nyhus L. M. Donor selection for renal transplantation based on genotypic analysis of HL-A in a family. Arch Surg. 1970 Aug;101(2):219–225. doi: 10.1001/archsurg.1970.01340260123020. [DOI] [PubMed] [Google Scholar]
  7. Kashiwagi N., Brantigan C. O., Brettschneider L., Groth C. G., Starzl T. E. Clinical reactions and serologic changes after the administration of heterologous antilymphocyte globulin to human recipients of renal homografts. Ann Intern Med. 1968 Feb;68(2):275–286. doi: 10.7326/0003-4819-68-2-275. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Kjellstrand C. M., Simmons R. L., Goetz F. C., Buselmeier T. J., Shideman J. R., Von Hartitzsch B., Najarian J. S. Renal transplantation in patients with insulin-dependent diabetes. Lancet. 1973 Jul 7;2(7819):4–8. doi: 10.1016/s0140-6736(73)91944-2. [DOI] [PubMed] [Google Scholar]
  9. Lopez C., Simmons R. L., Touraine J. L., Park B. H., Kiszkiss D. F., Najarian J. S., Good R. A. Discrepancy between PHA responsiveness and quantitative estimates of T-cell numbers in human peripheral blood during chronic renal failure and immunosuppression after transplantation. Clin Immunol Immunopathol. 1975 May;4(1):135–142. doi: 10.1016/0090-1229(75)90047-1. [DOI] [PubMed] [Google Scholar]
  10. MERRELL M., SHULMAN L. E. Determination of prognosis in chronic disease, illustrated by systemic lupus erythematosus. J Chronic Dis. 1955 Jan;1(1):12–32. doi: 10.1016/0021-9681(55)90018-7. [DOI] [PubMed] [Google Scholar]
  11. Mannick J. A., Davis R. C., Cooperband S. R., Glasgow A. H., Williams L. F., Harrington J. T., Cavallo T., Schmitt G. W., Idelson B. A., Olsson C. A. Clinical use of rabbit antihuman lymphocyte globulin in cadaver-kidney transplantation. N Engl J Med. 1971 May 20;284(20):1109–1115. doi: 10.1056/NEJM197105202842001. [DOI] [PubMed] [Google Scholar]
  12. Markland C., Kelly W. D., Buselmeier T., Kjellstrand C., Simmons R., Najarian J. Renal transplantation into ileac urinary conduits. Transplant Proc. 1972 Dec;4(4):629–631. [PubMed] [Google Scholar]
  13. Najarian J. S., Kjellstrand C. M., Simmons R. L., Buselmeier T. J., von Hartitzsch B., Goetz F. C. Renal transplantation for diabetic glomerulosclerosis. Ann Surg. 1973 Oct;178(4):477–484. doi: 10.1097/00000658-197310000-00010. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Najarian J. S., Simmons R. L. The clinical use of antilymphocyte globulin. N Engl J Med. 1971 Jul 15;285(3):158–166. doi: 10.1056/NEJM197107152850310. [DOI] [PubMed] [Google Scholar]
  15. Opelz G., Mickey M. R., Terasaki P. I. HL-A and kidney transplants: reexamination. Transplantation. 1974 Apr;17(4):371–382. doi: 10.1097/00007890-197404000-00006. [DOI] [PubMed] [Google Scholar]
  16. Rapaport F. T., Dausset J. Ranks of donor-recipient histocompatibility for human transplantation. Science. 1970 Feb 27;167(3922):1260–1262. doi: 10.1126/science.167.3922.1260. [DOI] [PubMed] [Google Scholar]
  17. Seigler H. F., Gunnells J. C., Jr, Robinson R. R., Ward F. E., Amos D. B., Rowlands D. T., Burkholder P. M., Klein W. J., Stickel D. L. Renal transplantation between HL-A identical donor-recipient pairs. Functional and morphological evaluation. J Clin Invest. 1972 Dec;51(12):3200–3215. doi: 10.1172/JCI107147. [DOI] [PMC free article] [PubMed] [Google Scholar]
  18. Sheil A. G., Kelly G. E., Mears D., May J., Johnson J. R., Ibels L. S., Stewart J. H. Antilymphocyte globulin in patients with renal allografts from cadaveric donors. Late results of a controlled trail. Lancet. 1973 Aug 4;2(7823):227–228. doi: 10.1016/s0140-6736(73)93132-2. [DOI] [PubMed] [Google Scholar]
  19. Simmons R. L., Condie R., Najarian J. S. Antilymphoblast globulin for renal allograft prolongation. Transplant Proc. 1972 Dec;4(4):487–490. [PubMed] [Google Scholar]
  20. Simmons R. L., Kjellstrand C. M., Buselmeier T. J., Najarian J. S. Renal transplantation in high-risk patients. Arch Surg. 1971 Aug;103(2):290–298. doi: 10.1001/archsurg.1971.01350080206032. [DOI] [PubMed] [Google Scholar]
  21. Simmons R. L., Moberg A. W., Gewurz H., Soll R., Tallent M. B., Najarian J. S. Immunosuppressive assay of antilymphoblast globulin in man: effect of dose, histocompatibility, and serologic response to horse gamma globulin. Surgery. 1970 Jul;68(1):62–68. [PubMed] [Google Scholar]
  22. Simmons R. L., Thompson E. J., Kjellstrand C. M., Yunis E. J., Condie R. M., Mauer S. M., Buselmeier T. J., Najarian J. S. Parent-to-child and child-to-parent kidney transplants. Experience with 101 transplants at one centre. Lancet. 1976 Feb 14;1(7955):321–324. doi: 10.1016/s0140-6736(76)90082-9. [DOI] [PubMed] [Google Scholar]
  23. Turcotte J. G., Feduska N. J., Haines R. F., Freier D. T., Gikas P. W., McDonald F. D., Johnson A. G., Morrell R. M., Thompson N. W. Antithymocyte globulin in renal transplant krecipients. A clinical trial. Arch Surg. 1973 Apr;106(4):484–488. doi: 10.1001/archsurg.1973.01350160102016. [DOI] [PubMed] [Google Scholar]

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