Cadaveric renal transplantation: our experience at the Institute of Kidney Diseases & Research Centre, Institute of Transplantation Sciences, Ahmedabad.
In a developing country such as India, cadaveric renal transplantation accounts for only less than 1% of total renal transplantations. The reasons for such a low rate of cadaveric transplantation are many, ranging from lack of awareness to socioeconomic reasons. Our institute conducted a statewide public awareness program and initiated an intercity organ harvesting program. This doubled the cadaveric renal transplantations in the last 2 years. We performed 38 cadaveric transplantations among 190 renal transplantations in the last year (August 2005 to July 2006). We retrieved kidneys from 21 donors, of whom 9 were outside our city. From 21 donors we transplanted 38 recipients; out of whom 3 received dual kidneys and one kidney was discarded. The Mean age of the donors was 41.4 +/- 18.2 years with a mean cold ischemia time of 6.9 +/- 3.8 hours. Sixty-eight percent had delayed graft function. At the last follow-up, which was 190 +/- 98 days, patient survival rate was 90%: 4 patients died, including 2 due to bacterial sepsis and 2 due to cytomegalovirus (CMV) disease. The Graft survival rate was 85%, and the death-censored graft survival rate was 90%. Mean serum creatinine value at the last follow-up was 1.2 +/- 0.3 mg%. There were 5 episodes of acute rejection in 31 patients during first 3 months (16% acute rejection rate). The increase in cadaveric transplantations was associated with satisfactory patient and graft survival despite the high incidence of delayed graft function.
Feroz
A
A
Department of Nephrology and Transplantation Medicine, Dr H L Trivedi Institute Of Transplantation Sciences, Ahmedabad, Gujarat, India. ikdrcad1@sancharnet.in
Dabhi
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Gumber
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Gupta
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Shah
P R
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Rizvi
S J
SJ
Modi
P R
PR
Shah
S A
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Khemchandani
S
S
Bhandari
N S
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Bhosale
G P
GP
Shah
V R
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Trivedi
V B
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Dave
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AP
Dave
J M
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Trivedi
H L
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D000328:Adult; D002102:Cadaver; D003906:Developing Countries; D006801:Humans; D007194:India; D016030:Kidney Transplantation / Q000706:statistics & numerical data*; D008875:Middle Aged; D014019:Tissue Donors; D020858:Tissue and Organ Harvesting / Q000379:methods