Early Experience of Kidney Transplantation in a New Center

Abstract

Objective: Kidney transplantation is one of the most important treatments in end-stage renal disease (ESRD). We aimed to share our experiences in 60 (57 deceased donors, 3 living donors) kidney transplantation cases performed in our center between July 2017 and August 2020. Material and methods: The demographic data of 60 patients with kidney transplantation performed in our kidney transplant center were evaluated in terms of causes and duration of renal failure human leucocyte antigen (HLA) tissue compatibility, immunosuppressive protocol used, antimicrobial agents, rejection status, graft loss, patient loss, postoperative surgical complications. Results: 57 of our kidney transplants were made from deceased donors and 3 from living donors. The mean age of the patients was 44.66 (23-68) years. Kidney transplantation was performed in 8 patients (13.33%) in the preemptive period. The mean number of mismatches in kidney transplants was 3.95 (2-5) and the mean duration of renal replacement therapy (RRT) was 54.73 (0-270) months. While the mean follow-up period after transplantation was 18.86 (2-37) months, it was observed that the mean cold ischemia time was 742.8 (60-1080) minutes. Serum creatinine levels of 56 patients with functional grafts at the end of the first month 1.39 (0.5-4.9) mg/dL, 54 patients at the end of the sixth month, creatinine levels 1.29 (0.56-5.9) mg/dL, The creatinine levels of the 52 patients as of October 2020 were 1.37 (0.75-5.16) mg/dL. As surgical complications, hematoma developed in 5 patients (8.33%) and lymphocele in 3 patients (5%). Early graft loss developed in one patient with renal artery embolism and two patients with renal vein thrombosis, while chronic rejection developed in two patients. We performed a deceased kidney transplant again 14 months later in a patient who developed graft loss in the early period due to renal vein thrombosis. The kidney inserted later is functional in the 10th postoperative month. One of our patients died due to rhino-orbital mucor mycosis in the postoperative 2nd month, and one patient due to the development of sepsis due to infection in the hip prosthesis in the postoperative 6th month, while another patient died due to myocardial infarction in the postoperative 2nd month. Conclusion: As a result, our kidney transplant center is in development. Our results obtained from 60 kidney transplants, almost all of which were performed from deceased donors, seem to be compatible with the literature. More detailed results can be obtained with the long-term follow-up results and the increase in the number of living donor transplants.

Keywords

• kidney transplantation
• rejection
• graft loss