The fate of patients surviving 3 years after renal transplantation

One hundred and ninety eight recipients of kidneys transplanted between 1963 and 1972 have survived longer than 3 yr and have followed a minimum of 4 yr. Currently 178 (89.9%) survive; 144 (73.2%) have their original graft. The authors analyzed the cause of death and risk factors of the 20 patients who died 3 or more years after transplantation. Of these 12 died as a result of infection (6 viral; 6 bacterial). In the majority, infection was endogenous or related to operation or a foreign body. Primary exogenous infection was rare. Six deaths were caused by cardiovascular accidents; hypertension may have been a predisposing factor. Suicide and cancer were each responsible for one death. The authors were surprised to find that 15 of the 20 patients had normal renal function (serum creatinine <2mg per 100 ml) at the time of death. The deaths in this group of patients frequently were unexpected because the recipients appeared to be doing well after transplanation.