title: Challenges in renal transplantation in Yemen.
abstract: Background Renal replacement therapy was first introduced in Yemen in 1978 in the form of hemodialysis. Twenty years later, the first renal transplantation was performed. Kidney transplantations were started in socially and financially challenging circumstances in Yemen in 1998. A structured program was established and has been functioning regularly since 2005. A pediatric transplantation program was started in 2011. Material and Methods This was a prospective study of 181 transplants performed at the Urology and Nephrology Center between May 1998 and 2012. All transplants were from living related donors. The immunosuppressive protocol consisted initially of double therapy with steroid and mycophenolate mofetil (MMF). Subsequently, triple therapy with addition of a calcineurin inhibitor was introduced. Primary graft function was achieved in 176 (97.2%) recipients. Results Cold ischemia time was 48-68 min. Episodes of acute rejection in 12 patients were treated with high-dose steroids. Anti-thymocyte globulin (ATG) was used in cases of vascular or steroid-resistant rejection in 2 patients. The post-transplant complications, either surgical or medical, were comparable to those recorded in the literature. Conclusions Renal transplantation is a good achievement in our country. The patients and graft survival rates are comparable to other reports.
authors: Urology and Nephrology Center, Al-Thawra Hospital, Sana'a University, Sana'a, Yemen.
authors: Ibrahiem H
authors: IH
authors: El-Nono
authors: Urology and Nephrology Center, Al-Thawra Hospital, Sana'a University, Sana'a, Yemen.
authors: Khaled A
authors: KA
authors: Telha
authors: Urology and Nephrology Center, Al-Thawra Hospital, Sana'a University, Sana'a, Yemen.
authors: Gamil M
authors: GM
authors: Al-Alimy
authors: Urology and Nephrology Center, Al-Thawra Hospital, Sana'a University, Sana'a, Yemen.
authors: Abdulilah M
authors: AM
authors: Ghilan
authors: Urology and Nephrology Center, Al-Thawra Hospital, Sana'a University, Sana'a, Yemen.
authors: Nagieb W
authors: NW
authors: Abu Asba
authors: Urology and Nephrology Center, Al-Thawra Hospital, Sana'a University, Sana'a, Yemen.
authors: Abdo M
authors: AM
authors: Al-Zkri
authors: Urology and Nephrology Center, Al-Thawra Hospital, Sana'a University, Sana'a, Yemen.
authors: Abdulilah M
authors: AM
authors: Al-Adimi
authors: Urology and Nephrology Center, Al-Thawra Hospital, Sana'a University, Sana'a, Yemen.
authors: Tawfiq H
authors: TH
authors: Al-Ba'adani
mesh_terms: D065095:Calcineurin Inhibitors / Q000627:therapeutic use*; D005260:Female; D006084:Graft Rejection; D006085:Graft Survival; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D007676:Kidney Failure, Chronic / Q000601:surgery*; D016030:Kidney Transplantation / Q000379:methods / Q000401:mortality*; D008297:Male; D009173:Mycophenolic Acid / Q000031:analogs & derivatives* / Q000627:therapeutic use; D011446:Prospective Studies; D015996:Survival Rate; D016896:Treatment Outcome; D015006:Yemen
chemical_list: D065095:Calcineurin Inhibitors; D007166:Immunosuppressive Agents; D009173:Mycophenolic Acid