Living related renal transplantation in Ireland: a sixteen year review.

Between January 1972 and December 1987, a total of 777 transplants were performed of which 135 (17%) were living related. There were 108 sibling donors, 25 parent to child and 2 child to parent. All sibling transplants were HLA identical. Conventional immunosuppression with Prednisone and Azathioprine was used in all cases. Actuarial patient survival were 95%, 91% and 88% at 1, 5 and 10 years respectively. Corresponding actuarial graft survivals were 90%, 80% and 60%. Graft survival in the sibling compared to the parent to child group was 87% versus 60% at 5 years. There were 13 deaths during the study interval and 32 grafts were lost. Five year patient/graft survivals of 91/80% compare favourably with other reported series. The poorer outcome in parent to child transplants has led us to modify the immunosuppressive protocol to include Cyclosporin A in this group. The increased availability and improved survival of cadaveric grafts in recent years and our one year patient/graft survival of 92/88% has led us to reduce emphasis on living related transplantation in our renal replacement programme.