One-month Serum Creatinine Level is the IndePendent Predictor of Long Term Graft Function Following Renal Transplant

Cho, Tae Ho; Kwon, Oh Jung; Kang, Jong Myoung

Abstract

PURPOSE: The current organ shortage in renal transplantation underscores the importance of optimizing long- term graft survival. Despite the significant improvement in the results of renal transplantation since the introduction of cyclosporine, graft loss after fist year of transplantation remains a significant and unresolved problem. This study showed renal function at 1 month after transplantation as a prognostic factor influencing long-term renal graft survival.
METHODS
The results of 683 cases of renal transplantations performed from 1978 to 2001 in our center were analysed. We divided into 3 groups according to the serum creatinine level (group 1: <1.5, group 2: 1.5~2.0, group 3: 2.0<) at first month of transplantation. And risk factors such as donor age (<60 or >60), donor sex, donor type (related, unrelated, cadevaric), recipient age (<60, or >60), recipient sex, HLA matching, acute rejection, delayed graft function were also analysed.
RESULTS
The acute rejection rates in each group were 17.1%, 40.6%, 71.7% retrospectively (P=0.000). The frequencies of delayed graft function were 3.9%, 9.0%, 36.2% retrospectively (P=0.000). There was significant difference of graft survival between each group (P=0.000). In addition, graft survival in group with acute rejection showed significant difference according to creatinine level at 1 month.
CONCLUSION
We can predict long-term graft survival and early renal function through serum creatinine levels after transplantation. Therefore, serum creatinine level at first month of transplantation was prognostic factor in predicting long-term graft survival.