LONG-TERM RENAL-ALLOGRAFT FUNCTION

Long-term function of transplanted kidneys was measured as Cr-51 EDTA clearance (GFR). All kidneys transplanted in 1985 with preserved function after 6 months were again studied after 12, 24, 36, and 60 months. Grafts lost due to the patient's death were excluded. There was no significant GFR difference at 6 months between grafts with continued function (median 42 ml/min, range 15-79 ml/min; n = 69) and those that failed later (median 39 ml/min, range 20-87 ml/min; n = 18). Median GFR of surviving grafts remained stable, but individual variations included reductions by 5-49 ml in 29 patients and increases by 5-33 ml in 22 patients. Nine of the failing grafts showed a continuous but rarely linear decline, while eight had initially increased GFR. The long-term GFR changes were not statistically correlated with the dosage of cyclosporin at 6 months or with later dose reductions. In conclusion, renal transplant function may deteriorate in the long-term but can also improve.