More than 25 years together: bases for a long-life span kidney transplant

ABSTRACT Graft survival for 20 years or more is not uncommon; they are called ultra-long kidney recipients. It is interesting to know if there are patterns in donors and recipients that could be reproduced. A retrospective cohort with 22 adult patients with a kidney renal transplant performed more than 25 years ago is analyzed. The mean of age of the donors was 24 years (median 21 years), 82% were males and the cause of death was mainly acute traumatic brain injury. Recipients had a mean of 34 years (median 36 years) at the time of the transplantation; the most common underlying renal disease was glomerular, without evidence of recurrence. 21 patients had compatibility in HLA II (one in 11 cases; two in 5 cases). Only 6 patients have had any episode of acute rejection; three of them have developed antibodies class I, but no DSA. In this retrospective cohort increases in donor age are associated with poor renal function. The mean creatinine is 1.43 mg/dl (0.97-2.14) and mean proteinuria is 653,43 mg/g (55-3722). The characteristics common in ultra- long- kidney recipients are young male donors, a shortage of episodes of rejection and good HLA compatibility, especially in class II antigens.