CARDIOVASCULAR COMPLICATIONS AFTER CADAVERIC RENAL TRANSPLANTATION

Abstract

Objective: Renal transplantation is the treatment for end-stage renal disease. Cadaveric donor renal transplantation (CDRT) is still uncommon in Tunisia, constituting less than 20% of total renal transplants. The aim of our study was to evaluate the results and cardiovascular complications in our center Design and method: A retrospective analysis of 30 CDRT was performed between November 1995 and December 2018. Data analysis included. age, gender, cold ischemia time, graft function graft function, dialysis requirements dialysis requirements, rejection episodes rejection, infectious episodes, new onset diabetes after transplantation (NODAT), hypertension and cardiovascular events Results: Thirty patients underwent CDRT among 172 renal transplants performed in our unit. Among the donors, there were 23 males and 7 females, with a mean age of 32 ± 9 years. All transplants were blood group compatible with 3 HLA matches in the majority of cases (45%). The mean age of the recipients was 34 ± 9 years. Chronic glomerulonephritis (40%) and chronic chronic interstitial nephropathy (32%) represented the main type of native renal disease. 88.5% of the patients were hemodialysis before transplantation and the median time to transplantation on dialysis was dialysis was eight years. The mean nadir of creatinine was 108 ± 27 μmol/l. Two biopsies showed acute tubular injury, four patients had acute rejection and two patients had allograft nephropathy allograft nephropathy with one case of segmental and focal hyalinosis. segmental and focal hyalinosis. The major infectious complication was a cytomegalovirus cytomegalovirus infection (33.3%) followed by a urinary tract infection (23.8%). Regarding metabolic complications metabolic complications, NODAT and hypertension were observed in three and four patients respectively. Two patients presented an acute coronary syndrome treated with medical therapy. Five patients returned to dialysis. The rest (57.7%) have been followed up regularly in our consultation so far over a period of 87 months (range 16-209 months). Conclusions: CDRT is not common in our center, but the analysis shows good results and provides encouraging data that support broadening the criteria for potential donors eligible for organ donation especially in the face of increasing organ shortages. Cardiovascular complications are not as common