Experience of renal transplantation at the king fahd hospital, jeddah, saudi arabia

Abstract

The renal transplant program at the Jeddah Kidney Center (JKC), The King Fahd Hospital, Jeddah commenced in November 1990. Since then, 746 patients have undergone renal transplantation in this center. Post-transplantation immunosuppresion in our patients comprised of prednisolone, azathioprine and cyclosporin. More recently, mycophenolate in place of azathioprine and tacrolimus in place of cyclosporine has been used in select groups of patients. Following surgery, delayed graft function was encountered in 131 (17.6%) of our renal transplant patients. Of them, 101 (77.1%) recovered completely while 30 (22.9%) either recovered partially or lost their graft completely and returned to dialysis. We encountered 94 (12.6%) acute rejection episodes. All these patients were treated with methylprednisolone administered in a dose of 250-500 mg intravenously on three consecutive days. Forty-seven (50%) responded favorably while the remaining 47 patients proved to have steroid-resistant rejection. Complete recovery with recovery of normal graft function occurred in 70 cases (74.5%), while 24 cases (25.5%) remained with mild renal impairment. Post-transplant diabetes mellitus was diagnosed in 126 patients (16.8%). Post-transplant hypertension was diagnosed in 399 patients, a prevalence of 53.4%, which agrees with the figures of previous reports. Post-transplant hyperlipidemia was reported in 355 patients (47%). We encountered 12 cases of urine leak and obstruction while lymphoceles were diagnosed in 20 patients. Urinary tract infections were the most prevalent infection in the first month post-transplant and occurred in 59 patients (7.9%). The other common infections in the early post-transplant period were wound infection and infection of subcutaneous collections /hematomas which occurred in 22 patients (2.9%).Overall, the 3, 5 and 10-year graft survival rates are 92%, 90% and 84% respectively. The patient survival after 1, 3, 5 and 10-years post-transplant is 98%, 96%, 90% and 90% respectively. Our results and outcome data of our renal grafts and patients show that renal transplantation is a highly successful modality of renal replacement therapy in our hospital.