Determinants of long-term survival of adult kidney transplants: a 1999 UNOS update.

Half-lives presented in Figure 11 summarize our findings regarding the long-term determinants of adult renal transplantation. The Figure's groups were created by cross-classifying various levels of the more important/interesting determinants identified through the multifactor analysis (Tables 1 & 2). As indicated by the black bar, half of all 16-30 year-old cadaveric kidneys transplanted into Caucasian recipients who survive beyond one year after transplantation will function for 14 years (i.e., the half-life equals 14 years). Unfortunately, in Blacks and Caucasians receiving an older donor kidney, the renal graft half-life falls to 6-8 years. When a Caucasian patient receives a spouse's kidney for transplant, the half-life increases to 17 years; when a Caucasian patient receives a HLA-matched cadaveric kidney, the half-life increases to 19 years; and, when an Asian patient receives a 16-30 year-old cadaveric kidney, the half-life jumps to 22 years. Finally, Caucasian patients receiving a HLA-identical sibling donor transplant enjoyed the greatest half-life of 26 years.