Debabrata Mukherjee1, Ranjith K Nair1, Sourabh Sharma2, Bhaskar Datt3, Ananth Rao2, Sudeep Prakash2. 1. Senior Advisor (Nephrology), Army Hospital (Research & Referral), Delhi, India. 2. Senior Resident (Nephrology), Army Hospital (Research & Referral), Delhi, India. 3. Classified Specialist, (Nephrology), Army Hospital (Research & Referral), Delhi, India.
Abstract
BACKGROUND: Renal transplantation in developing countries like India is largely live donor transplantation. Cadaveric transplantation comprises <2% of all transplants in India. METHODS: Ninety-two cadaveric renal transplantations were included. Various donor and recipient characteristics were analysed along with graft and patient survival, using Kaplan-Meier method. RESULTS: The mean age of the recipients was 35.5 ± 10.9 years while that of cadaver was 43.9 ± 17.0 years. Proportion of females among recipients was 47.8% while that of donors was 34.8%. The most common underlying pathology was chronic glomerulonephritis (44.6%). Antithymocyte globulin was used as induction in 84.8% of cases. Tacrolimus-based triple-drug regimen was most commonly used as maintenance (80.4%). The mean follow-up time was 39.02 ± 28.24 months. The most common cause of death was sepsis (47%). More than 50% deaths (9/17) occurred within first 3 years, while 61.5% of graft loss occurred 5 years after transplantation. The mean graft survival time was 81.6 months (95% confidence interval [CI]: 72.8-90.4). Cumulative proportion of graft survival was 91.6% at 3 years and 77.1% at 5 years. Although females have better mean graft survival time (91.6 vs 73.5 months), it was not a significant difference as shown by log-rank test (p value = 0.062). Pretransplant haemodialysis has no significant effect on graft loss, but patients on peritoneal dialysis have significantly higher odds of graft loss (odds: 4.86, p value < 0.05 [0.018]). The mean patient survival time was 99.5 months (95% CI: 84.0-114.9). Cumulative proportion of patient survival was 83.3% at 3 years and 70.8% at 5 years. CONCLUSION: Graft and patient survival rate of cadaveric transplant at our centre was satisfactory. There is need to sensitise and augment the rate of cadaveric transplantation to increase the donor pool.
BACKGROUND: Renal transplantation in developing countries like India is largely live donor transplantation. Cadaveric transplantation comprises <2% of all transplants in India. METHODS: Ninety-two cadaveric renal transplantations were included. Various donor and recipient characteristics were analysed along with graft and patient survival, using Kaplan-Meier method. RESULTS: The mean age of the recipients was 35.5 ± 10.9 years while that of cadaver was 43.9 ± 17.0 years. Proportion of females among recipients was 47.8% while that of donors was 34.8%. The most common underlying pathology was chronic glomerulonephritis (44.6%). Antithymocyte globulin was used as induction in 84.8% of cases. Tacrolimus-based triple-drug regimen was most commonly used as maintenance (80.4%). The mean follow-up time was 39.02 ± 28.24 months. The most common cause of death was sepsis (47%). More than 50% deaths (9/17) occurred within first 3 years, while 61.5% of graft loss occurred 5 years after transplantation. The mean graft survival time was 81.6 months (95% confidence interval [CI]: 72.8-90.4). Cumulative proportion of graft survival was 91.6% at 3 years and 77.1% at 5 years. Although females have better mean graft survival time (91.6 vs 73.5 months), it was not a significant difference as shown by log-rank test (p value = 0.062). Pretransplant haemodialysis has no significant effect on graft loss, but patients on peritoneal dialysis have significantly higher odds of graft loss (odds: 4.86, p value < 0.05 [0.018]). The mean patient survival time was 99.5 months (95% CI: 84.0-114.9). Cumulative proportion of patient survival was 83.3% at 3 years and 70.8% at 5 years. CONCLUSION: Graft and patient survival rate of cadaveric transplant at our centre was satisfactory. There is need to sensitise and augment the rate of cadaveric transplantation to increase the donor pool.
Authors: Georgi Abraham; Sunil Shroff; Karopadi Shivanand Nayak; Jayakumar Matcha; Mohan Rajapurkar; Yuvaram N V Reddy; Varun Sundaram; Yogesh N V Reddy Journal: Kidney Int Date: 2010-03 Impact factor: 10.612
Authors: A Ghafari; A Taghizade Afshari; Kh Makhdoomi; N Sepehrvand; M Gasemi-Rad; S Z Shamspour; N Maleki; T Abbasi Journal: Transplant Proc Date: 2009-09 Impact factor: 1.066
Authors: A Feroz; M Dabhi; M Gumber; S Gupta; P R Shah; S J Rizvi; P R Modi; S A Shah; S Khemchandani; N S Bhandari; G P Bhosale; V R Shah; V B Trivedi; A P Dave; J M Dave; H L Trivedi Journal: Transplant Proc Date: 2007-04 Impact factor: 1.066