Evaluation of long-term outcomes of deceased donor renal transplantation in patients with end-stage renal disease

Abstract

Introduction: Kidney transplantation is the most viable and cost-effective treatment option for patients with end-stage renal disease (ESRD). However, the limited availability of living donors opens up the option of utilizing deceased donor for kidney transplantation. Objectives: This study evaluated the long-term graft and recipient outcomes of deceased donor kidney transplantation (DDRT) in patients with ESRD. Patients and Methods: A retrospective analysis of ESRD patients who underwent DDRT (January 2002 to December 2018) was conducted. Transplant medical records were reviewed for the recipient’s demographic profile, causes of ESRD, type of transplants, type of induction treatment, and five-year follow-up data related to graft survival and mortality. Results: A total of 147 DDRT recipients with a mean age of 43.1 years were included. Male preponderance (66.67%) was observed. The common causes of ESRD were chronic glomerulonephritis (44.7%) and diabetic nephropathy (22.7%). Post-transplantation, patients were administered with induction therapy (anti-thymocyte globulin (ATG), 57.14%; basiliximab, 27.21%; and other induction agents, 15.65%). Patient survival rate at 1-year, 3-year and 5-year follow-up were 91%, 86% and 73%, respectively and graft survival rates were 89%, 79%, and 68%, respectively. Infection (87.07%) was the leading cause of death, followed by cardiovascular disease (11.56%). Conclusion: Long-term outcomes up to 5-years related to patient survival and graft survival in ESRD patients’ post-DDRT were satisfactory and suggested the use of DDRT as a replacement option for living donors.

Keywords

• Deceased donor
• ESRD
• Renal transplantation
• Survival outcomes