LONG-TERM PROGNOSIS OF RENAL-TRANSPLANT SURVIVING FOR OVER 10-YEAR, AND CLINICAL, RENAL AND REHABILITATION FEATURES OF 20-YEAR SUCCESSES

Long-term mortality and morbidity was evaluated in 267 patients with a minimum follow-up of 10 yr and the physical status, graft function an d quality of life in 15 patients with a functioning graft surviving fo r over 20 yr were reviewed. Actual patient and graft survival rates we re 80.2% and 51.1% at 10 yr (n=267) and 56.4% and 32.7% at 20 yr (n=55 ), respectively. Although the rate of graft failure due to rejection w as 4 times higher than that of patient death within 10 yr, it decrease d to the level of patient death in the second decade. Dominant causes of death in patients with graft surviving for over 10 yr were hepatic failure due to viral hepatitis and malignancies. In 15 patients with g raft currently surviving beyond 20 yr, while all patients have excelle nt graft function, malignancy occurred in 5, viral hepatitis in 3, ase ptic necrosis in 3, and diabetes mellitus in one patient. No patient h as suffered cardiovascular complications. Despite a high rate of morbi dity, they show a satisfying status of rehabilitation (full time worki ng 11/15, 73.3%). In order to attain more improved QOL in patients wit h long term surviving renal transplant, close follow-up aiming at dimi nution of complications is required throughout the period after transp lantation.