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Harrison's Principles of Internal Medicine, 18e
| Part 13. Disorders of the Kidney and Urinary Tract > |
Chapter 282. Transplantation in the Treatment of Renal Failure
Sections: Transplantation in the Treatment of Renal Failure: Introduction, Recent Activity and Results, Recipient Selection, Donor Selection, Tissue Typing and Clinical Immunogenetics, Immunology of Rejection, Immunosuppressive Treatment, Clinical Course and Management of the Recipient, Malignancy, Further Readings.
Topics Discussed: kidney failure; kidney failure, chronic; renal transplantation.
Excerpt:"Transplantation of the human kidney is the treatment of choice for advanced chronic renal failure. Worldwide, tens of thousands of these procedures have been performed. When azathioprine and prednisone initially were used as immunosuppressive drugs in the 1960s, the results with properly matched familial donors were superior to those with organs from deceased donors: 75–90% compared with 50–60% graft survival rates at 1 year. During the 1970s and 1980s, the success rate at the 1-year mark for deceased-donor transplants rose progressively. Currently, deceased-donor grafts have an 89% 1-year survival and living-donor grafts have a 95% 1-year survival. Although there has been improvement in long-term survival, it has not been as impressive as the short-term survival, and currently the "average" (t1/2) life expectancy of a living-donor graft is around 20 years and that of a deceased-donor graft is close to 14 years...."
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