Outcome of Kidney Transplantation in Bahrain.

Abstract

Pupose: Renal transplantation is considered the optimal form of renal replacement therapy for patients with end stage renal disease. Kidney transplantation was started in Bahrain in 1995 at our unit. Methods: Between June 1995 and December 2013, 125 renal transplants in 124 patients were performed at our unit. There were 115 living related donor and 20 deceased donor transplants (DD), including 81 male and 44 female patients. Most of the recipients were Bahraini (94.1%) and 116 (92.8%) of them received their first graft. Diabetic nephropathy was responsible for 22.4% of end-stage kidney disease. Their age ranged from 3 to 66 years and the follow up period was 1 to 216 months postoperatively. Results: Dialysis before transplantation was done in 85.4% of patients. All patients received triple drug immunosuppression and induction therapy with baziliximab. There were a total of 22 (17.7%) episodes of acute rejection diagnosed clinically and/ or by graft biopsy. Most of the rejection episodes occurred within the first month post-transplantation. Seven (5.6%) grafts had primary non-function due to acute tubular necrosis (ATN), and all of them were from DD. There were 15 episodes of severe infection. Seven patients died from their infection including three due to severe respiratory tract infection. Three patients developed cytomegalovirus infection which was diagnosed on clinical and serological grounds. Three patients developed malignancy (one lymphoma, one Kaposi sarcoma and one brain tumor). There were 3 surgical and urological complications encountered in our patients. At the last follow-up visit, there are 86 patients (68.8%) have good graft function. Thirty-eight patients lost their graft, 16 of them due to death with functioning grafts. The commonest cause of graft loss was chronic rejection. Conclusions: The overall results in our center are comparable to those published from other centers in the Arab World. Our main challenge is shortage of kidney donors.