title: Outcome of deceased donor renal transplantation - a single-center experience from developing country.
abstract: Renal transplantation (RTx) is considered as the best therapeutic modality for patient suffering from end-stage renal disease (ESRD). Dearth of donor kidneys is a major problem everywhere, and deceased donor renal transplantation (DDRTx) is seen as at least a partial solution. Even so, DDRTx accounts for only less than 4% of RTx in India. We report our 6-year single-center experience on DDRTx vis-à-vis patient/graft survival, graft function in terms of serum creatinine (SCr), rejection episodes, and delayed graft function (DGF). Between January 2005 and March 2011, 236 DDRTx were performed. Majority of the donors were those with brain death due to road traffic/cerebrovascular accidents. The commonest recipient diseases leading to ESRD were chronic glomerulonephritis (42.8%), diabetes (12.7%), and hypertension (10.6%). Mean recipient age was 36.2 ± 14.2 years; 162 were males and 74 were females. Mean donor age was 45.3 ± 17.13 years; 144 were males and 92 were females. Mean dialysis duration pre-transplantation was 18.5 ± 2.5 months. All recipients received single-dose rabbit-anti-thymocyte globulin induction and steroids, calcinueurin inhibitor, and mycophenolate mofetil/azathioprine for maintenance immunosuppression. Delayed graft function was observed in 29.6% patients and 22% had biopsy-proven acute rejection. Over the mean follow-up of 2.18 ± 1.75 years, patient and graft survival rates were 74.57% and 86.8%, respectively, with mean SCr of 1.42 ± 0.66 mg%. DDRTx achieves acceptable graft function with patient/graft survival, encouraging the use of this approach in view of organ shortage.
authors.affiliation: Department of Nephrology and Clinical Transplantation, Dr. H. L. Trivedi Institute of Transplantation Sciences, Ahmedabad, India. drhvpatel@gmail.com
authors.forename: Himanshu V
authors.initials: HV
authors.lastname: Patel
authors.forename: Vivek B
authors.initials: VB
authors.lastname: Kute
authors.forename: Ghanshyam H
authors.initials: GH
authors.lastname: Ghelani
authors.forename: Aruna V
authors.initials: AV
authors.lastname: Vanikar
authors.forename: Pankaj R
authors.initials: PR
authors.lastname: Shah
authors.forename: Manoj R
authors.initials: MR
authors.lastname: Gumber
authors.forename: Hargovind L
authors.initials: HL
authors.lastname: Trivedi
mesh_terms: D000328:Adult; D001926:Brain Death; D051799:Delayed Graft Function / Q000453:epidemiology; D003906:Developing Countries; D046148:Donor Selection; D005260:Female; D006084:Graft Rejection / Q000453:epidemiology; D006085:Graft Survival; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007194:India / Q000453:epidemiology; D007676:Kidney Failure, Chronic / Q000401:mortality / Q000601:surgery*; D016030:Kidney Transplantation / Q000009:adverse effects / Q000401:mortality; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016019:Survival Analysis; D013997:Time Factors; D014019:Tissue Donors / Q000600:supply & distribution*; D016896:Treatment Outcome
chemical_list: D007166:Immunosuppressive Agents