Iran is a one of leading countries in renal allograft transplantation (RT) and Living donors have always been the basic resources of transplantation in our country, where cadaveric harvesting is still hampered for various reasons.
Objective: to construct a national model of prognostic factors leading to graft and patients survival.
Methods: From July 1984 to December 2005, 4588 RT cases were performed in Labbafi nejad and Baqyiatallah hospitals, Tehran, Iran of whom 3028 cases included because of favorable follow up data. The analyzed variables were donor relationship, recipient age and sex, donor age and sex, Viral hepatitis B&C infections. Graft survival rate was assessed with the Kaplan-Meier method and the significance of possible variables with the Cox proportional hazard model.
Results: a total number of 3028 RT recipients (94.8% first RT, 63.4% male, mean±SE of age in RT 36.4±0.3 years, mostly got ESRD due to Glomerolunephritis, Hypertension and Diabetes Mellitus) were studied. One, five, ten and 15 years graft survival were 85.4%, 68.2%, 46.2% and 27.4% respectively and for patients survival were 95,4%, 87.5%, 79.9% and 76.3% respectively. Most of cases lost graft function due to chronic rejection (86.3%). Donor age (Relative Hazard [RH]: 1.024, P<0.001), Unrelated donors (RH:1.7, P<0.001) and Hepatitis C Virus (HCV) Infection (RH: 2.65, P<0.001) were the only significant factors effecting graft survival.
Conclusion: increased donors age, unrelated donor and HCV infection rate both are the most important factors on graft rejection rate and proper management of these factors may led to more graft functioning and survival.