Open AccessCadaveric kidney allotransplantation at Krasnoyarsk Regional Clinical Hospital
Author(s) -
V.S. Arutiunian,
А. В. Кеосьян,
Mikhail A. Firsov,
Д. П. Евдокимов,
М. Р. Цокаев,
Olga S. Amelchugova,
Э. В. Лукичева
Publication year - 2021
Publication title -
vestnik transplantologii i iskusstvennyh organov
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.137
H-Index - 5
eISSN - 2412-6160
pISSN - 1995-1191
DOI - 10.15825/1995-1191-2021-2-41-51
Subject(s) - medicine , kidney disease , reflux nephropathy , surgery , nephropathy , allotransplantation , kidney transplantation , renal function , transplantation , diabetes mellitus , disease , reflux , vesicoureteral reflux , endocrinology
Objective : to evaluate the early and long-term outcomes of cadaveric kidney allotransplantation (CKAT) based on a retrospective analysis of 71 cases treated at Krasnoyarsk Regional Clinical Hospital (KRCH). Materials and methods . From March 2014 to June 2019, 71 kidney transplants were performed at KRCH – 42 (59.15%) men and 29 (40.85%) women. The age of the patients varied from 20 to 59 years (mean age 39.6 ± 8.14 years). The causes of end-stage chronic kidney disease which subsequently led to CKAT were chronic glomerulonephritis, chronic tubulointerstitial nephritis, hypertensive nephropathy (HN), diabetic nephropathy resulting from type I diabetes (DN), nephropathy of mixed genesis (HN + DN), vesicoureteral reflux, congenital angiodysplasia of the kidneys, and Alport syndrome. The mean number of HLA mismatches was 4.5 ± 0.9. Results . Hospitalization lasted for an average of 34.05 ± 9.56 days. Primary function was observed in 32 (45.08%) patients, while 39 (54.92%) cases had delayed function. Post-transplant complications were noted in 23 (32.39%) patients, of whom 12 (16.9%) had early post-transplant complications, while 15 (21.13%) encountered complications in the late post-transplant period. The most frequently diagnosed were immunological, infectious, and urological complications. Vascular, surgical, oncological, and other complications were less frequent. The annual graft survival rate was 87.3%. Patient survival rate was 95.77%. One (1.4%) and 2 (2.81%) patients died in the early and late post-transplant periods, respectively. Hospital mortality – 1 case (1.4%). Conclusion . Kidney transplantation is the most effective treatment for patients with irreversible chronic kidney disease. About 87.33% of transplants were found to be effective. However, 32.39% of patients had postoperative complications. The vast majority of complications were reversible and were corrected conservatively or surgically. Nevertheless, graft loss occurred in 12.67% of cases. The success of transplantation depends on a number of factors related to both the donor and the recipient, as well as the immunological status and surgical technique. A personalized approach to recipients helps to reduce postoperative complications, prevent nephrotoxicity and rejection reactions.