Long Time Complications of Renal Transplantation

Document Type : Original Article (s)

Authors

1 Associate Professor, Department of Surgery, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

2 Medical Student, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

Abstract

Background: Renal transplantation is the end of renal failure treatment in patients with end stage renal disease (ESRD). It is a well-known model of renal eplacement therapy for end-stage renal disease patients in developed and developing countries. This model of treatment has widely been used in our country in recent years. The present study was undertaken to investigate the long tome complications and survival time of transplanted kidney in Alzahra hospital, Isfahan.Methods: In a cross sectional study long time complications of kidney transplantation such as infection, cardial and renal were studied .This retrospective study reviewed patient population in terms of age, sex, etiology of transplantation reject, using corticosteroid drugs and survival time for new kidney. The data recorded in special questionnaire and entered to computer and analyzed by SPSS software. The chi square, paired-t, and Kaplan Meyer tests were used for data analysis.Finding: 130 patients (42 women, 88 men) who had been under kidney transplantation were studied between Jan. 1382 and Jan.1385. The patients mean age was 46.3 ± 14.5 years. The frequency distribution of long time complications of transplantation include renal, cardiac and infection were 10%, 3.1%, and 36.9% respectively.Conclusion: Kidney transplantation is a method of choice for treating of ESRD patients. The most common cause for discontinuing renal efficacy is long time complication specially infection in transplantation site.

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  1. Schulman G, Himmelfarb J .Hemodialysis .in: Brenner BM, Rector ,Floyd c. The kidney: Philadelphia, Saunders company, 2004:2564
  2. Kasper DL , Fauci AS, Longo DL, Braunwald E, Hauser SL, Jameson JL, Harrison’s Prin-ciples of internal medicine; Mc Graw-Hill companies, 2005:1653
  3. Schulman G, Himmelfarb J. Hemodialysis. In: Brenner BM, Rector, Floyd C. The kidney: Philadelphia, Saunders company, 2004:2565
  4. Ratcliffe PJ, Phillips RE, Oliver DO: Late referral for maintenance dialysis. Br Medj(Clin Res Ed) 1984;288: 441-443.
  5. Eadington DW: Delayed referral for dialysis. Nephrol Dial Transport1996;11: 2124-2126.
  6. Soh T.Davgirdas , Handbook of dialysis , third edition .2001;373-393
  7. National Kidney foundation: K/DOQI clinical practice guidelines in chronic kidney disease: Evaluation, classification and stratification. J Kidney Dis 39: 51-52 66, 2002.
  8. Skorecki K, Green J, M.Brenner B. Chronic renal failure. Mc Graw-Hill companies, 2005:1653
  9. Mannon RH: Polyomavirus nephropathy: What have we learned? Transplantation 2004;77: 1313-1318.
  10. Mannon RH: Polyomavirus nephropathy: What have we learned? Transplantation 2004;77: 1313-1318.
  11. National Kidney foundation: K/DOQI clinical practice guidelines in chronic kidney disease: Evaluation, classification and stratification. J Kidney Dis 2002; 39: 51-52 66.
  12. Manzler AD, Schreiner AW: Copper-induced acute hemolytic anemia: A new complication of hemodialysis. Ann Intern Med 1970;13: 409-412.
  13. Lentino JR, Leehey DJ, Infections .in: Daugti-das JT, Ing TS, Blake P6. Handbook of dialysis: Philadelphia, Lippincot Williams and wilkins, 2001: 499.
  14. Bloembergen WE, Port FK, Epidemiological Perspective on infections in chronic dialysis patients. Adv Ren Replace Ther 1995; 3: 201-7.
  15. Wolfe RA, Ashby VB. Comparison of mortali-ty in all patients on dialysis, patients on dialysis awaiting transplantation, and recipients of a first cadaveric transplant. N Engl J Med 1999 ;341: 1725-173.
  16. Sayegh MH, Carpenter CB: Transplantation 50 years later: Progress, challenges, and prom-ises. N Engl J Med 2004 ;351: 2761-2766.
  17. Kaplan B, Meier-Kriesche HU: Renal transplantation: A half century of success and the long road ahead. J Am Soc Nephrol 2004;15: 3270-3271.
  18. Meier-Kriesche HU, Schold JD,- Srinivas TR, Kaplan B: Lack of improvement in renal allo-graft survival despite a marked decrease in acute rejection rates over the most recent era. Am J Transplant 2004 ; 4: 378-383.
  19. Mehrabi A, Wiesel M, Zeier M, Kashfi A, Schemmer P, Kraus T, et al. Results of renal transplantation using kidneys harvested from living donors at the University of Heidelberg. Nephrol Dral Transplant, 2004, 19: Suppl 4: iv48-iv54.
  20. Terasaki PI, Cecka JM, Gjertson DW, Takemo-to S. High survival rates of kidney transplants from spousal and living unrelated donors. N Engl J Med 1995, 333 (6):333-336.
  21. Foss A, Leivestad T, Brekke IB, Fauchald P, Bentdal O, Lien B, et al. Unrelated living do-nors in 141 kidney transplantations: a one-center study. Transplantation 1998, 66(1): 49-52.
  22. Hoen B, Paul-Dauphin A, Hestin D, Kessler M. EPIBACDIAL: a multi center prospective study of risk factors for bacteremia in chronic hemodialysis patients. J am Soc Nephrol 1988; 9: 869-76.
  23. Kaplowitz LG, Comstock JA, Landwehr DM, Dahon HP, Mayhall CG. A prospective study of infections in hemodialysis patients: Patient hygiene and other risk factors for infection: Infect Control Hosp Epidemiol 1988; 9: 534-41.
  24. Bonomo RA, Rice D, Whalen C, Linn D, Eck-stein E, Swaes DM. Risk Factors a ssociated with permanent access-site in fections in chronic hemodialysis patients. Infect Control Hosp Epidemiol 1977; 18: 757-61.
  25. Churchill DN, Taylor DW, Cook RJ, et al. Canadian hemodialysis morbidity study. Am I Kidney Dis 1992;15: 214-34.
  26. Powe NR, Jarr B, Furth SL, Hermann J, Briggs W. Septicemia in dialysis patients: incidence, risk factors, and prognosis. Kidney Int 1999; 55: 1081-90.