RENAL TRANSPLANT AND ITS OUTCOMES- SINGLE CENTER EXPERIENCE FROM INDIA

KL GUPTA1, N PATTANASHETTI1, A SHARMA1, R RAMACHANDRAN1, R NADA1, R AGARWAL1
1Postgraduate Institute of medical Education and Research , Chandigarh, India

Introduction: Renal transplantation is the treatment of choice for a majority of patients with end stage renal disease. Marked improvement in early graft survival and long term graft function has made kidney transplantation a more cost effective alternative to dialysis.
Method: Prospective observational study carried in a Tertiary care centre in India from July 2016 to Dec 2017, included all patients underwent renal transplant from July 2016- Feb 2017 (8 months), followed for 9 months to assess the incidence of rejections, opportunistic infections and outcomes of renal transplants.
Results: Total 122 patients, 22(16.4%) female, 102(83.6%) males, mean age 35.61± 10.64 yrs, (92, 75.4%) from lower socioeconomic status. 52(42.6%) 10 related donor, 34(27.9%) spousal donor, 24(19.7%) deceased donor and 12(9.8%) 20/30 related donor. All patients underwent only CDC cross match due to financial constraints. 50(41%) had blood transfusion history. Induction ATG 60(49.2%), Basiliximab 8(6.6%) and nil 54(44.3%). 40(30.1%) underwent biopsy for graft dysfunction, 32(26.22%) rejection {18(14.75%) pure ABMR+5(4.09%) pure TCMR+9(7.37%) combined (ABMR+TCMR)}, 11(9.1%) biopsy proven CNI toxicity, 1(0.8%) BKV nephropathy and 1(0.8%) recurrence C3 GN. 24.5% had opportunistic infections, CMV(10.7%), Tuberculosis(5.7%), Aspergillosis(3.3%), HSV(1.7%), Cryptococcosis(1.7%), Nocardia(0.8%) and BKV(0.8%). 29(24%) had NODAT and MMF intoleranc 26(21.5%). 93(76.2%) had normal graft function, 21(17.21%) chronic graft dysfunction, graft loss 3(2.4%), and death 5(4.09%). ABMR was higher in related donor compared to spousal donor (28.8% Vs 14.7%), History of blood transfusion (p=0.001) predicted the occurrence of ABMR and induction used showed trend towards prediction(p-0.083).
Conclusion: At the end of follow up, only three quarter had normal graft function, higher rejection rate due inadequate immunological work up, higher infection and death rate may be due to financial constraints and low socioeconomic status.


Biography:
Dr K L Gupta is Professor of Nephrology and Head of Department at The prestigious Postgraduate Institute of Medical Education and Research at Chandigarh India. He has been serving as the faculty member since 1983. His Mai areas of interest include Fungal Infections following Renal translation as well as angio-invasive Fungal Infections of the native kidneys and Lupus Nephritis. He has been awarded many fellowship including FASN, FRCP (London) , FAMS, FISOT, FISN etc. He is currently the President of the Indian Society of Organ Transplantation and President of the Nephrology, Urology and Transplantation Society of SAARC Countries.

Recent Comments
    Categories