Open AccessEFFECT OF WARM ISCHEMIA TIME AND HLA (A AND B) MATCHING ON RENAL CADAVERIC GRAFT SURVIVAL AND REJECTION EPISODES
Author(s) -
Andr Es,
J. Hermans,
J.H. van Bockel,
G. G. Persijn,
J. P. van Hooff,
J. De Graeff
Publication year - 1983
Publication title -
transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.45
H-Index - 204
eISSN - 1534-6080
pISSN - 0041-1337
DOI - 10.1097/00007890-198309000-00006
Subject(s) - ischemia , medicine , cadaveric spasm , kidney , kidney transplantation , transplantation , warm ischemia , cold ischemia , survival analysis , renal ischemia , surgery , urology , reperfusion injury
In a retrospective single-center study the influence of warm ischemia time and simultaneous influence of HLA (A and B) matching on one-year renal graft survival was analyzed in 170 adult recipients of primary cadaveric renal grafts. One-year survival of grafts with warm ischemia times longer than 50 min was only 40% (n = 10). When warm ischemia time was shorter than 50 min, a 1-min increase of warm ischemia time correlated with 1% decrease in one-year graft survival as a result of rejection. This detrimental effect of warm ischemia time on graft survival was not yet significant one month after transplantation, but became more evident as follow-up time was lengthened. Warm ischemia time also correlated with the number of reversible rejection episodes in patients with a graft functioning for longer than one year (P less than 0.04). The beneficial influence of HLA (A and B) matching on one-year graft survival was significant (P less than 0.05 log linear test). This influence was even more evident with longer warm ischemia times. It is concluded that warm ischemia has a detrimental influence on graft survival that is mediated by rejection, and it is suggested that this might be due in part to altered presentation or expression of HLA-antigens of ischemically damaged kidney tissues.