Indian Journal of Transplantation (Jan 2017)
Outcome of live donor kidney transplantation in a Government Hospital of Nepal
Abstract
Background: Live donor kidney transplantation (KT) was started in 2008 in Bir Hospital, a government hospital of Nepal. The present study aims to find out patient and graft outcome, and the factors influencing the graft survival. Methods: It is a retrospective analysis of all KT from December 2008 to May 2013. The immunosuppressive was induction with intravenous methylprednisolone and daclizumab (n = 39) or basiliximab (n = 34) or anti-thymocyte globulin (n = 22) and maintenance with steroid, calcineurin inhibitors (CNIs), and mycophenolate mofetil. All data of recipients and donors were obtained from hospital records. Kaplan–Meier method was used for survival analysis. Results: Totally, ninety-five patients with follow-up duration of 1.5–6.5 years were analyzed. Recipients and donors were disproportionate in age (74.7% vs. 16.8% below 40 years) and gender (87.4% male vs. 77.9% female), respectively. Delayed graft function was observed in 10.5%, and slow graft function in 9.5% of patients with recovery of graft function before discharge in all except two. Within 2 years, 4.2% patients died because of infection and sepsis. Graft loss was observed in 14.7% due to antibody-mediated rejection (noncompliance 50% and unaffordability to treat 21.4%) and recurrent glomerulonephritis (28.6%). Patient survival at 1, 3, and 6.5 years was 97.9%, 95.8%, and 95.8%, respectively. Death noncensored graft survival was 97.9%, 86.2%, and 77.5%, respectively and death censored graft survival was 100%, 90%, and 80.9%, respectively with no influence of induction agents and recipient and donor factors in graft survival. Conclusion: The early and intermediate-term patient and graft outcome is satisfactory and low socioeconomic status related noncompliance is the major cause of graft loss.
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