Natural History of Cadaveric Kidney Transplants in the Absence of Early Acute Rejection

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Abstract
The foremost goal in organ transplantation is to achieve normal graft function without rejection. Of 357 cadaveric kidney transplants, 31 (8.7%) had no evidence of rejection for the first 3 mo. Among these, 2 patients died with a functioning graft and 4 grafts failed during the 1-7 yr follow-up period. Actuarial graft survival rates of these patients were 96.8 and 79.0% at 2 and 5 yr, compared with 64.6 and 51.2%, respectively, for the controls (P < 0.01). Multiple preoperative blood transfusions and the adjunctive immunosuppressive therapy with retroplacental .gamma.-globulin appeared to be playing a role for the induction of the no-rejection state. Continuous immunosuppressive therapy is apparently necessary to maintain graft function.