An audit and comparative analysis of the kidney transplantation programme in Burma.
BACKGROUND
The first renal transplant operation to be carried out by a Burmese transplant team was undertaken at the Yangon General Hospital, Burma on the 8th of May 1997. Since then 21 further kidney transplantations have been performed in hospitals in Yangon (Rangoon) and Mandalay. Burma was renamed as Myanmar in 1989. The Myanmar national renal transplant programme was introduced and performed as a special project organised by the Ministry of Health. Unfortunately little is known in other countries about the programme's development or the outcomes of the patients treated.


OBJECTIVE
In August 2003, the author visited Myanmar with the intention of evaluating the progress that this programme had made in the last six years.


METHODS
Retrospective data concerning all recipients and donors involved in the Myanmar renal transplant programme was obtained from the patient databases and through personal meetings with staff at the Urology and Nephrology units in Yangon and Mandalay.


RESULTS
All 22 cases were blood related living donor transplants. There were 14 males and 8 female donors with a mean age of 36.5 (28-53) years and 13 male and 9 female recipients with a mean age of 38.3 (19-60) years included in the programme. There was a 100% survival rate of all 22 donors and a 95% (n = 21) recipient survival rate recorded in the programme up to September 2003. The one-year graft survival rate is 95% (n = 21) and the overall graft survival rate until September 2003 is 91% (n = 20), the mean follow-up was 2 years and 4 months.


CONCLUSIONS
The success of this programme is extremely impressive considering the turbulent socio-economic climate in this developing country. The next steps for Myanmar are to organise a domestic registry system for transplants, the organisation of personnel to take responsibility for data collection, distribution and greater communication with other transplant units.
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Guy's, King's and St. Thomas' School of Medicine, London, UK.