Predictive survival after kidney transplantation. An analysis of risk factors.

One hundred consecutive kidney transplants in 89 patients performed at a single center were analyzed to assess the relationship between patient survival and various high-risk factors present prior to transplantation. Each individual risk factor was given a relative weight which contributed to a cumulative risk index for each patient. Based on these risk indices, patients were placed in four risk categories: 1) good risk, 2) high risk, 3) very high risk, and 4) extremely high risk. Analysis of the survival data for each of these groups indicated that as the risk increased, survival decreased. Actuarial patient survival for the good risk group (n = 37) and high risk group (n = 27) were 97.2 per cent and 88.5 per cent, respectively. The very high risk group (n = 15) and extremely high risk group (n = 21) had decreased survival of 45.8 per cent and 38.2 per cent, respectively. Therefore, although our system of high-risk classification is not fully evolved, its application even in the present form could be of considerable aid in transplantation decision making.