The 12th Annual Report of the North American Pediatric Renal Transplant Cooperative Study: renal transplantation from 1987 through 1998.

摘要: : The North American Pediatric Renal Transplant Cooperative Study (NAPRTCS) presents an annual report for all transplants registered from January 1987 onwards. In this we reviewed 6,534 renal recorded 5,958 patients who had entered the study by 1999, and attempted to identify changes in practice patterns that led improved graft survival. There has been a steady decline cadaver source nationally our accrual 1996 1997 reflected trend. also decrease number of infants young children receiving transplant recent years. From peak 23.3% 1987–91 cohort, current shows under 6 yr age now account only 20.4% transplants. Changing disease rates progression have decreased percentage Caucasian registry, 68.5% first 5 yr 62.9% most cohort. markedly reduced use donor (CD) kidneys (recovered donors younger than 10 yr age) 35% 1991 22% report. Acute rejection are identical CD living (LD) grafts 2 weeks post-transplant. comparative percentages on days 30 45 36% 44% CD, 26% 32% LD recipients respectively. By end year post-transplant, 45% 60% acute rejection. marked improvement ability reverse initial episode rejection; 1987, 52% were completely reversed recipients, 61% reversed. Rejection continued be lower maintained cyclosporin A (CsA) doses > 6.4 mg/kg. One-, 3-, 5-yr survival probabilities 91%, 85%, 80%, respectively, 83%, 73%, 65% recipients. Comparative 1- 3-yr figures 88% 81% 74% 63% When short-term (1 yr) results compared, significant was demonstrated 71.7% 1987/88 92.6% 1998/1999 Hence, changing gradually brought very close continuing incidence rejections more years should translate into further delay onset chronic rejection, thus improving longevity.