title: Renal Transplantation - An Experience of 500 Patients.
abstract: BACKGROUND
  Renal transplantation is the treatment modality of choice for patients with end stage kidney failure. We present our experience of graft and patient survival of initial 500 renal transplants performed between May 1991 and July 2006, at Army Hospital (R&R).
  
  
  METHODS
  All patients received triple drug immunosuppression with cyclosporine/tacrolimus, azathioprine/ mycophenolate mofetil and steroids. Patients in high risk group received induction therapy with IL-2 receptor blockers/anti-thymocyte globulin.
  
  
  RESULTS
  Majority of the recipients (79%) were males, whereas majority of the donors (59.4%) were females. In the donor profile, 385 (77%) transplants were live related, 108 (21.6 %) were spousal and 7 (1.4%) were cadaveric transplants. Mean age of the donors and recipients was 42.11 ± 11.53 years (range 19-72 years) and 33 ± 9.39 years (range 5-60 years) respectively. Eighty two patients (16.4%) were lost to follow up and the present data on rejections, patients and graft survival pertains to 418 patients. These patients have been followed up for a mean period of 2.63 years (SE, 0.122; median 1.8 years; range 0-13.36 years). Acute rejection episodes occurred in 115 (27.3%) patients and 95% of these could be reversed with steroids/ATG. Sixty eight patients (16%) have died on follow-up. Our one-year, 5 year and 10 year estimated graft survival is 95.4% (SE, 0.01), 80.5% (SE, 0.03) and 53.1% (SE, 0.09) respectively and patient survival at one year is 93.2% (SE, 0.01). The estimated graft and patient survival in our series is 9.83 (95% CI, 8.92-10.73) and 9.80 (8.93-10.67) years respectively.
  
  
  CONCLUSIONS
  This centre's short-term graft survival of 95.4% is comparable to the best centres of the world.
authors.affiliation: Senior Advisor (Medicine & Nephrology), Army Hospital (Research & Referral), Delhi Cantt.
authors.forename: P P
authors.initials: PP
authors.lastname: Varma
authors.affiliation: Senior Advisor (Medicine & Nephrology), Army Hospital (Research & Referral), Delhi Cantt.
authors.forename: A K
authors.initials: AK
authors.lastname: Hooda
authors.affiliation: Senior Advisor (Surgery & Urology), Army Hospital (Research & Referral), Delhi Cantt.
authors.forename: T
authors.initials: T
authors.lastname: Sinha
authors.affiliation: Senior Advisor (Pathology & Immunopathology), Army Hospital (Research & Referral), Delhi Cantt.
authors.forename: G S
authors.initials: GS
authors.lastname: Chopra
authors.affiliation: Senior Advisor (Surgery & Urology), Army Hospital (Research & Referral), Delhi Cantt.
authors.forename: S C
authors.initials: SC
authors.lastname: Karan
authors.affiliation: Classified Specialist (Surgery) & Urologist, Army Hospital (Research & Referral), Delhi Cantt.
authors.forename: G S
authors.initials: GS
authors.lastname: Sethi
authors.affiliation: Classified Specialist (Pathology & Nephropathologist), Army Hospital (Research & Referral), Delhi Cantt.
authors.forename: S
authors.initials: S
authors.lastname: Badwal
authors.affiliation: Classified Specialist (PSM & Epidemiology), Army Hospital (Research & Referral), Delhi Cantt.
authors.forename: A
authors.initials: A
authors.lastname: Kotwal
keywords: Graft survival; Kidney transplant; Patient survival