TITLE:
Overview of Kidney Transplantation: A Single Centre Report from China
AUTHORS:
Kiran Jang Kunwar, Li Heng, Fuqing Zeng, Zhendi Wang
KEYWORDS:
Kidney Transplantation (KTx), ESRD—End Stage Renal Disease, Deceased Donor (DCD—Donor after Cardiac Death, DBD—Donor after Brain Death)
JOURNAL NAME:
Open Journal of Organ Transplant Surgery,
Vol.6 No.2,
May
5,
2016
ABSTRACT: Introduction: Worldwide,
End Stage Renal Disease (ESRD) is one of the leading disease with prolong
morbidity. Kidney transplantation offers the best solution for the problem. The
shortage of donor kidney is even bigger problem due to transplantation being
one of the routine procedures. The use of deceased donor definitely increases
the pool of donor with excellent immediate and long-term follow-up proven
results. Aim: The aim is to analyze and summarize the outcome of Kidney
transplantation. Methods & Materials: A total of 78 cases of Kidney
Transplantation were selected for the study and categorized as: Group I—41 (living
Donor), Group II—23 (DCD) & Group III—15 (DBD). Perspective study was done
with clean data recorded & maintained
pre-operatively, post-operatively and follow-up from Jan 2011 to Dec 2015
in our hospital. Post-operative graft status, complications and at least 1-year
follow-up were area of main focus. Results: All patients underwent successful
kidney transplantation. In Group I, the number of living donor kidney
transplantation is 41 whereas in Group II (DCD) & III (DBD), the number of deceased
donor transplantation is 23 and 15 respectively. The Normal functioning of
graft (NGF) was 38 (87.8%), 16 (69.6%) & 11 (73.3%) in Group I, II &
III respectively along with Poor Graft function (PGF) in Group I—4 (9.7%), II—5
(21.7%) & III—2 (13.3%) managed by continuing dialysis. Delayed graft
function (DGF) was noted I-1 (2.4%), II-2 (8.6%) & III-1 (6.6%) in
respective group, which returned to normal function post intervention.
Therefore, 1st year graft survival was >93% [(Group I (97.6%), Group
II (95.6%) & Group III (93.3%) respectively]. Manageable surgical
complication were found in Group I—8 (19.5%), Group II—5 (21.7%) & Group
III—2 (13.3%) like hematoma, hydronephrosis, leakage except one emboli related
nephrectomy of transplanted kidney & one pneumonia led death in Group II.
The overall survival was greater than 90% [(Group I (97.6%), Group II (91.3%)
& Group III (93.3%) respectively] in all three groups after at least 1-year
follow-up study, which was an excellent prognosis. Conclusion: Kidney
Transplantation is safe, effective and the best method of treatment for ESRD.
Significant improvement in quality of life is the hallmark merit over dialysis.
Paired donation program should be encouraged in order to overcome shortage of
kidney, which increases living donor pool. Outcome in living donor Kidney
transplantation is always better than deceased donor transplantation. The
prognosis of deceased donor transplantation (1 year Graft survival > 93%
& 1 year patient survival > 90%) is also satisfactory with promising
results. Therefore all the results were under acceptable standard limit. Thus,
kidney transplantation (live or deceased donor) should be encouraged as primary
modalities in the treatment of End Stage Renal Disease (ESRD).