Survival of Living Donor Renal Transplantation: Experience of a Single-Center

Abstract

BACKGROUND: Renal transplantation is the best treatment available for patients with end stage renal disease. The demand for transplants has been steadily rising in the face of diabetes epidemic, advancing age and epidemic of agricultural nephropathy. METHODS: This is a longitudinal descriptive study conducted retrospectively, where first living donor transplants that had possible follow up for three or more years included. Pre tested interviewer administered e-questionnaire was used to collect data. RESULTS: The median age of recipients and donors (n = 71) were 39 and 44 years respectively, median duration of dialysis before transplant was 8 months. Most of the recipients (70.6%) and donors (52.3%) were males, whose mean age (39.7 years) was significantly (p=0.011) higher than that of females (31.2 years). 65.5% of donors were either blood related or legally related to the recipient. Primary renal pathology was unknown for 47.9% of the recipients. The cohort had a mean of 2.5 (SD=1.4) HLA mismatches. 21.1% had acute rejection within the first month, and 19.7% had surgical complications. Recipient age or sex, donor age or sex, number of HLA mismatches, duration of dialysis, and number of dialysis cycles or surgical complications were not significantly associated with rejection within one month of transplantation. Proportions with one and three year graft survival were 95.9% and 93.1% respectively. Patient survival at one and three years were 88.5% and 83.6% respectively. Likelihood of living with a functional graft was 85.1% and 78.2% respectively at one and three years. Conclusions: Primary renal pathology is unknown in many recipients, and its patterns differ with each center. The survival rates of our unit are comparable to other local as well as international units