Journal of nephrology · 2026
Ultra-long survivors of kidney transplantation: forty years and more of graft function.
СтатьяНазвание и аннотация: Перевод в очереди
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Madden Michelle, Comerford Gavin, O'Kelly Patrick, Cooney Anne, O'Neill Liam, Elhassan Elhussein A E, Abdalla Alaeldin, Traynor Carol, Conlon Peter J, Irish Nephrology Society Research Group
Аннотация
BACKGROUND: It has been over 60 years since the first kidney transplant in Ireland was carried out in 1964. We examined the Irish cohort of individuals with allografts functioning for more than 40 years. We sought to describe the features of these patients and identify clinical factors associated with ultra-long-term allograft survival.
METHODS: This retrospective analysis of the Irish National Kidney Transplant Registry included kidney transplants performed in Ireland between January 1st, 1970, and March 31st, 1983. Follow-up analysis was until March 31st, 2023.
RESULTS: There were 428 transplants in 394 patients. Longitudinal data were available for 390 (98.9%) patients. Thirty-three (33/428, 7.7%) kidney transplant grafts survived for 40 years or more, with 25 grafts functioning at date of analysis. Multivariable analysis identified transplant type-living donor versus deceased donor (odds ratio [OR] 3.51, confidence interval [CI] 1.17-11.1, P = .027) as significantly associated with long-term graft survival. The median serum creatinine of patients with surviving transplants was 107 µmol/L (range 66-322 µmol/L). Non-melanoma skin cancer was common, affecting 22/33 (67%) patients.
CONCLUSIONS: For ultra-long survivors, graft function is excellent if patients are maintained on low-level immunosuppression. Living donor transplantation, but not donor or recipient age or sex, was associated with improved graft survival.
METHODS: This retrospective analysis of the Irish National Kidney Transplant Registry included kidney transplants performed in Ireland between January 1st, 1970, and March 31st, 1983. Follow-up analysis was until March 31st, 2023.
RESULTS: There were 428 transplants in 394 patients. Longitudinal data were available for 390 (98.9%) patients. Thirty-three (33/428, 7.7%) kidney transplant grafts survived for 40 years or more, with 25 grafts functioning at date of analysis. Multivariable analysis identified transplant type-living donor versus deceased donor (odds ratio [OR] 3.51, confidence interval [CI] 1.17-11.1, P = .027) as significantly associated with long-term graft survival. The median serum creatinine of patients with surviving transplants was 107 µmol/L (range 66-322 µmol/L). Non-melanoma skin cancer was common, affecting 22/33 (67%) patients.
CONCLUSIONS: For ultra-long survivors, graft function is excellent if patients are maintained on low-level immunosuppression. Living donor transplantation, but not donor or recipient age or sex, was associated with improved graft survival.