Risk factors for renal allograft survival in patients receiving cyclosporine immunosuppression

Background and purpose: Although cyclosporine (CsA) has been widely used in renal transplantation for more than 10 years, no large series of renal tra nsplant patients has been studied in southern Taiwan. The purpose of this r etrospective cohort study was to investigate the risk factors for graft sur vival in renal transplant recipients. Methods: From August 1987 to January 1998, 101 primary cadaveric renal tran splantations were performed. The minimum follow-up period was 1 year. CsA a nd prednisolone were initially used as immunosuppressive agents in all pati ents. Use of lower doses of CsA to reduce CsA trough level (50-99 ng/mL) in hepatitis B surface antigen (HBsAg)-positive recipients was attempted at 6 months after transplantation. Results: Graft actuarial survival rates at 1, 5, and 10 years posttransplan tation were 89%, 75%, and 57%, respectively. Acute rejection and increased recipient age were found to be significant risk factors (p < 0.05) affectin g graft survival, with hazard ratios of 5.20 and 1.74, respectively, by mul tivariate analysis using a Cox proportional hazards model. Hepatitis B and/ or hepatitis C infection had no influence on graft survival. Conclusions: In this series of cadaveric renal allograft patients, the risk factors affecting allograft survival were acute rejection and recipient ag e.