[Antigraft response in advanced age cadaveric renal recipients]. / Vyresnio amziaus recipientu imuninis atsakas i lavono inksto transplantata.

ABSTRACT

We aimed to compare graft loss due to acute rejection (AR) and chronic allograft failure (CAF) in first cadaveric kidney recipients, subsequently grafted during 1992-2000. All recipients (n=225) were divided into 3 age groups Gr 1 (n=39) - 13-25 yrs, Gr 2 (n=169) - 26-55 yrs and Gr 3 (n=47) 56-71 yrs. There were no differences between the groups in terms of sex (m/f ratio 1.2-1.4), ischemia time and HLA matching. Incidence of high presensitization (PRA> or =50%) were observed in 15%, 5% and 9%, correspondingly (statistically significant difference was found only between Gr 1 and Gr 2). Immunosuppression consisted of CyA, AZA or MMF and steroids. Antigraft response was evaluated by graft loss due to acute rejection or chronic allograft failure. Actuarial graft survival was estimated with the Kaplan-Meier method with p values given for log-rank test. Graft loss was censored for death of recipient with functioning transplant and other causes of loss not related to rejection. Graft survival was 77%, 86% and 100% at 1yr in groups 1, 2, 3; 74%, 78% and 88% at 3 yrs; 67%, 73% and 88% at 5 yrs; 54%, 65% and 88% at 7 yrs, correspondingly (for Gr 1-3 - p<0.005, for Gr 2-3 p<0.025). In conclusion, antigraft response in elderly cadaveric kidney recipients is weaker - the incidence of transplant rejection is smaller than in young and grown-up recipients.