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Abstract
One-hundred-and-twenty-four renal transplantations were performed in 109 patients between January 1965 and November 1968. Thirty-seven patients have died. the present analysis concentrates upon 56 transplants in 53 patients surviving 6-43 months. the relative number of patients surviving 6 months has increased with increasing experience of the team.
The limited validity of creatinine clearance and thus serum creatinine in assessing filtration rate at different levels of inulin clearance have been studied. the single injection inulin test (SIIT) parallelled closely the result of conventional inulin clearance at all levels but gave a somewhat low estimation of filtration rate.
A disproportionate decrease in inulin clearance in relation to PAH-clearance, leading to low or sometimes very low filtration fractions, was common. This usually preceded the onset of a nephrotic syndrome, but in some cases such a development has not been seen as yet.
A filtration rate of 50 ml/min or above at 6 and particularly at 12 months seemed to lead to a maintained or often increased filtration rate in the later course (18-42 months). Protein excretion at 6 months was in the majority of cases within normal limits or slightly elevated. of the patients who at 6 months had protein excretion values ranging from 750 mg to 2500 mg/hours, the majority had glomerulonephritis with an acute post-tonsillitic onset as their original disease. This was irrespective of the known duration of disease. Between 18 and 42 months, there was a shift towards massive proteinuria in 7 cases. Six of these had had glomerulonephritis with acute post-tonsillitic onset as their original disease.
At 6 months the filtration rate tended to be low in all patients with acute onset glomerulonephritis with less than 10 years known duration. the two lowest figures in the entire series were found in 2 acute onset patients with a duration shorter than 1 year.
High and maintained filtration rates and low protein excretion were found in all three grade A‐matches in this series and in some untyped cadaveric transplants. Grade C and D-matches showed a variable course, most often with signs of increasing proteinuria and deteriorating filtration rates in the prolonged course.