title: Renal Transplantation: Experience at a Single Centre.
abstract: BACKGROUND
  Renal transplantation program in the Armed Forces commenced in Feb 1991 and till date 245 patients have undergone renal transplantation at INHS Asvini. We describe our protocols for donor and recipient evaluation and immunosuppression.
  
  
  METHODS
  245 patients received renal transplants during this period, 243 (99.2%) being from live donors. Most of them were started on triple immunosuppression comprising of cyclosporine, azathioprine and prednisolone. Newer drugs like mycophenolate, tacrolimus and sirolimus were administered in a select population.
  
  
  RESULTS
  69 (28.1%) of them had at least one episode of acute rejection, most of which were steroid responsive and 13 (18.8%) of them required either anti CD3 monoclonal or anti-thymocyte globulin (ATG). Complete recovery with normal renal function occurred in 54 (78.2%) cases and 15 (21.7%) recovered with residual dysfunction with maximum serum creatinine being 2.1mg/dl. There were three (1.2%) cases of accelerated rejection during the first week of transplantation and one had graft rupture. All three lost their grafts. There were eight (3.2%) cases of acute tubular necrosis, who recovered completely within 8-14 days. Immediate infections included wound sepsis, lower respiratory tract infection, disseminated candidiasis and disseminated aspergillosis. Late infections included pulmonary tuberculosis, disseminated tuberculosis, cytomegalovirus infection and recurrent urinary tract infection. 28 (11.4%) patients developed post transplant diabetes mellitus. At the end of one year and five years, graft and patient survival were 97.2%, 93%, 80.9% and 85.7% respectively.
  
  
  CONCLUSIONS
  Our outcomes show that the transplantation is a viable mode of renal replacement therapy in patients of end stage kidney disease with a near normal rehabilitation.
authors.affiliation: Senior Advisor (Medicine & Nephrology), INHS Asvini, Colaba, Mumbai.
authors.forename: Msn
authors.initials: M
authors.lastname: Murty
authors.affiliation: Director General (O&P), Office of DGAFMS, Ministry of Defence, New Delhi.
authors.forename: V K
authors.initials: VK
authors.lastname: Saxena
authors.affiliation: Senior Advisor (Medicine & Nephrology), INHS Asvini, Colaba, Mumbai.
authors.forename: U K
authors.initials: UK
authors.lastname: Sharma
authors.affiliation: Classified Specialist (Surgery & Urology) INHS Asvini, Colaba, Mumbai.
authors.forename: S
authors.initials: S
authors.lastname: Tandon
authors.affiliation: Classified Specialist (Surgery & Urology) INHS Asvini, Colaba, Mumbai.
authors.forename: P
authors.initials: P
authors.lastname: Sharma
keywords: Complications; Immunosuppression; Kidney; Transplantation