Three Years of Kidney Transplantation Experience at a University Hospital

PURPOSE: Kidney transplantation is the preferred therapy for end-stage renal failure patients due to its advantages of improving survival and life quality. The aim of this study was to present the clinical and laboratory data of patients who were transplanted between October 2005 and December 2009 in our reformed kidney transplantation program.

METHODS: Seventy-nine patients (45 males, 34 females, mean age:32.4±10.9 years), received a kidney transplant during this period. The duration of renal replacement therapy was 34.7±40.3 months and 12 of the recipients were preemptive. Mean donor (35 males, 44 females) age was 41.2±14.5 years with a HLA-mismatch of 3.2±1.4.

RESULTS: The duration of follow-up was 19±11.6 months. Fifteen patients received a kidney from nine cadaveric donors, in which seven of them were donated in the last 12 months. Sixty-four patients received kidneys from living donors (40 laparoscopic, 24 open donor nephrectomies). Mean cold ischemia time for cadaveric donors was 686±289.6 minutes. Graft nephrectomies were performed for vascular problems in two patients; one of them developed primary nonfunction and the other one had received an en-bloc kidney transplant from a cadaveric donor. One patient was lost in the early posttransplant period. Serum creatinine levels were 1.24±0.55 and 1.23±0.47 mg/dl in the remaining 76 functioning allografts at the first and twelfth months respectively. A double-J catheter was placed for every patient with a removal time of 21.7±5.7days. Ten patients developed acute rejection episodes, eight were biopsy proven and nine patients were treated with good response for antirejection therapy. Four lmyphoceles, two venous thrombosis, two arterial thrombosis, one arterial stenosis, one urinary leak, one ureteral stricture, two hematomas and six wound infections were observed during the posttransplant period.

CONCLUSION: The first, second and third years of patient survival rates were all 99% while graft survival rates were 96% for each of the first three years. Besides these encouraging results, a remarkable increase in the number of cadaveric donations in the last 12 months implies the success of our program. A preemptive transplantation rate of 15% also seems promising.