Three-Year Experience of Kidney Transplantation at a Single Center in Uzbekistan.

Abstract

In this study, we analyzed the results of the first 100 kidney transplants from related donors performed at the Republican Research Center of Emergency Medicine in Uzbekistan. This study included 100 patients who underwent kidney transplant from a living donor at the Republican Research Center of Emergency Medicine from March 2018 to January 2021. Immediate graft function was noted in 84 cases (84%) and delayed graft function in 16 cases (16%). Delayed graft function occurred mainly when multiple vessels were present in a donor kidney (35.5%) compared with the presence of a single renal artery and vein (12.1%). The delayed graft function was influenced by the average duration of warm ischemia (80.26 ± 38.35 min with multiple arteries and 50.44 ± 14.44 min with a single renal artery and vein; P = .001). There were 3 cases (3%) of acute cellular rejection, which was successfully treated with pulse therapy and methylprednisolone; there was also 1 case (1%) of hyperacute rejection, which resulted in graft removal. Complications in the form of ureteral stenosis were noted in 2 cases (2%) and ureteral necrosis with anastomotic insufficiency in 1 case (1%). Two recipients (2%) underwent renal graft nephrectomy. In our short-term study, 1-year survival rate for kidney transplant patients was 93%, with graft survival rate of 91%. Delayed graft function developed when duration of warm ischemia was increased, which was influenced by the number of vessels in the donor kidney. This is an important prognostic factor for acute rejection development. The risk of vascular complications increases due to postoperative hemodialysis trough, with development of delayed graft function. Recipient deaths during the first year after kidney transplant were mainly from pulmonary embolism, infection, and sepsis as a result of immunosuppression, hypovolemic shock, and acute ischemic stroke.