A Retrospective Analysis of Renal Transplantation Patients: A Single Center Experience

Abstract

Aim: In this study, we aimed to present demographic characteristics of the patients having undergone renal transplantation in our hospital between February 2017 and September 2020, to convey the experience of cadaver and living donor renal transplantation in our center, and to reveal the causes of allograft dysfunction in late posttransplant follow-ups. Material and Method: The study included 25 patients having undergone renal transplantation in our hospital and were followed up in the nephrology clinic between February 2017 and September 2020. Then, we retrospectively analyzed their demographic characteristics, clinical and laboratory findings, transplantation types, kidney donor characteristics, renal failure etiologies, pre-transplant dialysis modalities, post-transplant complications, rejection attacks, graft loss, and causes of mortalities. Results: The mean follow-up period of 25 renal transplant patients (17 males and 8 females with a mean age of 46.96±2.67 years) was 26.28±2.76 months. While living transplantation was performed in 16 patients, the others received cadaveric renal transplants. Five patients underwent pre-emptive renal transplantation, and three were recruited for transplant for the second time. The underlying cause of chronic kidney disease was unknown in 24% of the patients (first), while vesicoureteral reflux (VUR) and diabetes were the primary causes of the disease in 16% (second). The most prevalent cause of temporary or permanent impairment in allograft functions was urinary tract infection with 42.8%. It was more common in female patients (25%) and patients with a diagnosis of VUR (20%). Conclusion: Overall, our findings documented that urinary system infections are common following renal transplantation, which brings adverse effects on allograft functions. VUR-led renal failure and female gender are among the factors that facilitate urinary system infection.

Keywords

• renal transplantation
• kidney function tests
• urinary tract infection

References

1. 1. Kidney Disease: Improving Global Outcomes (KDIGO) CKD Work Group. KDIGO 2012 clinical practice guideline for the evaluation and management of chronic kidney disease. KDIGO Kidney International Supplement. 2013;3(1):1–150.
2. 2. Ahmad N, Ahmed K, Khan MS, Calder F, Mamode N, Taylor J, et al. Living-unrelated donor renal transplantation: an alternative to living-related donor transplantation? Ann R Coll Surg Engl. 2008;90(3):247–50.
3. 3. Yıldız A. Böbrek nakli. İçinde: Yeniçerioğlu Y, Güngör Ö, Arıcı M. editörler. Temel Nefroloji. Ankara: Güneş Tıp Kitapevi; 2019. ss. 371–82.
4. 4. Murray J, Merrill J, Harrison J. Renal homotransplantation in identical twins 1955. J Am Soc Nephrol. 2001;12:201–04.
5. 5. Karakayali H, Haberal M. The history and activities of transplantation in Turkey. Transplant Proc. 2005;37:2905–08.
6. 6. Türkiye’de Nefroloji, Diyaliz ve Transplantasyon-Registry 2020. Ankara: Türk Nefroloji Derneği Yayınları; Miki Matbaacılık San. ve Tic. Ltd. Şti.; 2021.
7. 7. Türkiye’de Nefroloji, Diyaliz ve Transplantasyon-Registry 2019. Ankara: Türk Nefroloji Derneği Yayınları; Miki Matbaacılık San. ve Tic. Ltd. Şti.; 2020.
8. 8. Erek E. Nefroloji. İstanbul: Emek Matbaacılık; 1988. ss. 284–9.

9. 9. Lim WH, Clayton P, Wong G, Campbell SB, Cohney S, Russ GR, et al. Outcomes of kidney transplantation from older living donors. Transplantation. 2013:15;95(1):106–13.
10. 10. Noppakun K, Cosio FG, Dean PG, Taler SJ, Wauters R, Grande JP. Living donor age and kidney transplant outcomes. Am J Transplant. 2011;11(6):1279–86.
11. 11. Demir ME, Uyar M, Merhametsiz O, Sevmiş M, Aktas S, Sevmiş Ş. Results of renal transplantation from the very elderly deceased donors: an age-based view. Turkish Journal of Nephrology. 2021;30(2):145–53.
12. 12. Türkmen K, Erdur FM, Erikoğlu M, Gaipov A, Çolak B, Tekin A, et al. 2003–2011 Yılları arasında Meram Tıp Fakültesi Organ Nakli Merkezi’nde yapılan böbrek nakli olgularının sonuçları. Turk Neph Dial Transpl. 2013;22(1):34–44.
13. 13. Chuang P, Parikh CR, Langone A. Urinary tract infections after renal transplantation: a retrospective review at two US transplant centers. Clin Transplant. 2005;19(2):230–5.
14. 14. Çoban Ş, Yıldız S, Bozkaya E, Derici Z. S, Ünlü M, Çelik A, et al. Böbrek nakli alıcılarının morbidite, hasta ve graft sağkalımı yönünden değerlendirilmesi: Dokuz Eylül Üniversitesi Hastanesi Deneyimi. Turk Neph Dial Transpl. 2017;26(1):41–7.