Factors affecting outcome in deceased donor renal transplantation: a cohort study -a single centre experience

Author: 
Senthilvel Arumugam, Periasamy Ponnusamy and Rajesh Shivalingam

Introduction: Deceased donor renal transplantation (DDRT) is still infrequent in India, constituting less than 5% of the total renal transplants of about 3500 per year. Renal transplantation, the best RRT modality, is increasing in popularity, due to improvements made in public education and deceased donor transplantation (DDT) programme.
Aims and Objectives: The aim of this study is to identify factors affecting graft function in deceased renal transplantation. For this data of recipient and donor parameters were collected and analysed, its effects on graft function and development of delayed graft function (DGF) were evaluated.
Materials and Methods: A Retrospective and prospective analysis of 11 deceased donor renal transplants performed between March 2016 and March 2019 at Government Kilpauk Medical College and Government Royapettah Hospital, Chennai were done. All the transplants were blood group compatible. Various recipient and donor factors were evaluated and its relation to graft function was studied.
Results: Mean age of the recipients was 35.5 years (male: female ratio 5:6), and that of the donors was 33.6 years (male: female ratio 11:1). The mean cold ischemia time (CIT) was 7.4 hrs. Four had CIT <6hrs. Shortest CIT was 5.15hrs and the longest was 13.4hrs. Delayed graft function (DGF) was noted in 7 recipients and immediate graft function was noted in 4 patients. Cold ischemia time and development of DGF were important predictors of graft survival.
Conclusion: The two most important factors determining graft and patient survival in our study were cold ischemia time and attainment of graft functions immediately after transplant. The incidence of DGF was 64%, and acute rejection was 27.2%. DGF also noted in recipients with pre-existing combined medical illness,increasing donor age and decreased urine output in early postop period.

Download PDF: 
DOI: 
http://dx.doi.org/10.24327/ijcar.2019.17887.3408
Select Volume: 
Volume8