Abstract
To analyse the outcome of 50 consecutive cadaveric renal transplants performed in Sri Lanka. This was a single-centre longitudinal cohort study conducted in the Nephrology and Kidney Transplant Unit, Teaching Hospital Kandy, Sri Lanka. Records of 50 Sri Lankan cadaveric renal transplant recipients from 7th December 2004 to 1st September 2013 were reviewed and categorized according to early graft function, cold ischaemia time and the duration of dialysis before surgery. Out of the 50 patients, twenty one (42%) had immediate graft function (IGF), 26 (52%) delayed graft function (DGF), and 2 (4%) primary non function (PNF). The average cold ischaemia time (CIT) was 8.8 hours. Out of 23 patients who died during the study period, 19 (82.6%) died although they had a functioning graft. Infection was the commonest cause of death (n=15; 65.2%). Rejection occurred in four (17.4%). Patient survival was 77.3% at one year, 63.0% at three years and 46% at five years. Graft survival was 93.2% at one year, 88.9% at 3 years and 84.6% at 5 years when death with a functioning graft was censored. Univariate analysis revealed that neither CIT nor duration of dialysis before transplant affected patient survival. There was no significant difference in patient survival between DGF and IGF. The events occurring in the early period following renal transplantation do not have a significant impact on long term graft outcome or patient survival. Infection is the commonest cause of death after renal transplantation and efforts should be directed to understand and prevent this complication.
Highlights
Renal transplantation offers superior life expectancy and quality of life, compared to dialysis, in patients with end-stage renal disease (ESRD)
The events occurring in the early period following renal transplantation do not have a significant impact on long term graft outcome or patient survival
Infection is the commonest cause of death after renal transplantation and efforts should be directed to understand and prevent this complication
Summary
Renal transplantation offers superior life expectancy and quality of life, compared to dialysis, in patients with end-stage renal disease (ESRD). During the first postoperative year the risks of death for both transplantation and dialysis are not significantly different [2]. Long-term survival of patients who undergo transplantation is significantly better irrespective of their primary renal disease when compared to patients who are listed but remain on dialysis. Successful renal transplantation triples the life expectancy of a listed renal failure patient [2]. The main limiting factor for renal transplantation is the unavailability of donor kidneys. In this context, cadaveric renal transplantation at present seems to offer a more practical solution [3]
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