Results of kidney transplantation in University clinical centre Republic of Srpska in period from 2010-2018.

  • milorad - grujičić *Department of Nephrology and Plasmapheresis, Internal Medicine Clinic, University Clinical Center of the Republic of Srpska, Banja Luka, The Republic of Srpska, Bosnia and Herzegovina; †Faculty of Medicine, University of Banja Luka, The Republic of Srpska, Bosnia and Herzegovina;
  • Milan Žigić Clinic for Urology, University Clinical Center of the Republic of Srpska, Banja Luka, The Republic of Srpska, Bosnia and Herzegovina
  • Milanko Maksić
  • Slobodan Hajder
  • Darko Golić Univezitetski klinički centar Republike Srpske Medicinski fakultet Univerziteta u Banjoj Luci
  • Branislav Gašić
  • Dragan Rakanović Univezitetski klinički centar Republike Srpske Medicinski fakultet Univerziteta u Banjoj Luci
  • Novak Vasić Univezitetski klinički centar Republike Srpske
  • Nataša Laganin ||Clinic for Urology, University Clinical Center of the Republic of Srpska, Banja Luka, The Republic of Srpska, Bosnia and Herzegovina
  • Zoran Roljić Clinic for Vascular Surgery, University Clinical Center of the Republic of Srpska, Banja Luka, The Republic of Srpska, Bosnia and Herzegovina;
  • Ljubomir Stajčić Clinic for radiology, University Clinical Center of the Republic of Srpska, Banja Luka, The Republic of Srpska, Bosnia and Herzegovina;
  • Mirjana Mišković Clinic of Psychiatry, University Clinical Center of the Republic of Srpska, Banja Luka, The Republic of Srpska, Bosnia and Herzegovina;
  • Dubravka Mićić Zrnić *Department of Nephrology and Plasmapheresis, Internal Medicine Clinic, University Clinical Center of the Republic of Srpska, Banja Luka, The Republic of Srpska, Bosnia and Herzegovina;
  • Goran Topić *Department of Nephrology and Plasmapheresis, Internal Medicine Clinic, University Clinical Center of the Republic of Srpska, Banja Luka, The Republic of Srpska, Bosnia and Herzegovina;
  • Vlado Djajic ***Clinic for Neurology University Clinical Center of The Republic of Srpska, Bosnia and Herzegovina. Faculty of Medicine, University of Banja Luka, The Republic of Srpska, Bosnia and Herzegovina;

Abstract


Abstract

Background/Aim. Kidney transplantation is the best treatment for patients with end-stage renal disease (ESRD). The aim of the study was to show the results of kidney transplantation performed in the University Clinical Center of the Republic of Srpska in the period 2010-2017     Methods. This was a retrospective, 8-year observational cross-sectional study. Studied endpoints were overall patient survival, as well as graft survival rate in kidney transplant recipients. Recipient's age, gender, induction immunosuppressive therapy, the underlying cause of ESRD, the dialysis modality and post-operative complications (surgical, medical, urinary tract infections (UTIs), electrolyte imbalance, and graft rejection) and their influence on the patient and graft survival rates were monitored.

Results. The 30 living-donor kidney transplantations were performed, 29 living-related donor and 1 living-unrelated donor renal transplantation. 70% of kidney recipients were male, and 30% were female. The average age of patient was 34.43 ± 8.67 years. Induction immunosuppressive regimen was prescribed to 76.7% of transplanted patients. Graft rejection occurred in 5 patients (16.7%). The 1-year, 3-year, 5-year, and 8-year patients survival rates were 100%, 100%, 96.97% and 93.33%, respectively. Also 1-, 3-, 5-, and 8-year graft survival rates were 100%, 96.97%, 93.33% and 86.67%, respectively. The current mean value of glomerular filtration rate (GFR) in 25 patients with functional graft was 81.8 ± 30.3 mL/min. There was a statistically significant difference in the graft survival rate in the group with UTIs (66.66%) compared to a group without UTIs (100%). Overall patient survival was significantly shorter in the group with graft rejection (60%) compared to a group without graft rejection (92%). Kidney graft survival rate and overall patient survival have not been significantly different in terms of the studied factors (recipient’s age, gender, induction immunosuppressive treatment, underlying cause of ESRD, dialysis modality, surgical or medical complications, and electrolyte imbalance). Conclusion. The results of living-donor kidney transplantation performed in the University Clinical Center of the Republic of Srpska are good versus the results obtained at other centers.

Key words:

kidney transplantation; living donor; graft survival rate; patient survival rate

Introduction

References

Jha V, Garcia-Garcia G, Iseki K, Li Z, Naicker S, Plattner B, et al. Chronic kidney disease: global dimension and perspectives. Lancet 2013; 382(9888): 260-72.

Wolfe RA, Ashby VB, Milford EL, Ojo AO, Ettenger RE, Agodoa LY, et al. Comparison of mortality in all patients on dialysis, patients on dialysis awaiting transplantation, and recipients of a first cadaveric transplant. N Engl J Med 1999; 341(23): 1725-30.

Laupacis A, Keown P, Pus N, Krueger H, Ferguson B, Wong C, et al. A study of the quality of life and cost-utility of renal transplantation. Kidney Int 1996; 50(1): 235-42.

Rusell JD, Beecroft ML, Ludurin D, Churcill DN. The quality of life and cost utility of renal transplantation- a prospective study. Transplantation 1992; 56: 656-60.

Schnuelle P, Lorenz D, Trede M, Van Der Woude FJ. Impact of renal cadaveric transplantation on survival in end-stage renal failure: evidence for reduced mortality risk compared with hemodialysis during long-term follow-up. J Am Soc Nephrol 1998; 9(11): 2135-41.

Bašić Jukić N. it is possible to maintain the highest number of transplantation in Croatia in th e long term? Bantao J 2013; 11:49

Kandus A, Buturović Ponikvar J, Mlinšek G, Oblak M, Arnol M. Kidney Transplantation in Slovenia From 1970 to 2015. Ther Apher Dial 2016; 20(3): 229-33. doi: 10.1111/1744-9987.12428

Spasovski G, Busic M, Pipero P, Sarajlic L, Subotic Popovic A,Delmonico F, et al. Current status of transplantation and organ donation in the Balkans—could it be improved through the South-eastern European health Network (SEEHN) initiative? Nephrol Dial Transplant (2012) 27: 1–5

Brunet M, van Gelder T, Åsberg A, Haufroid V, Hesselink DA, Langman L, et al. Therapeutic Drug Monitoring of Tacrolimus-Personalized Therapy: Second Consensus Report. Ther Drug Monit. 2019 ;41(3):261-307.

Tonelli M, Wiebe N, Knoll G, Bello A, Browne S, Jadhav D, et al. Systematic review: kidney transplantation compared with dialysis in clinically relevant outcomes. Am J Transplant 2011; 11(10): 2093-109.

Gondos A, Döhler B, Brenner H, Opelz G. Kidney graft survival in Europe and the United States: strikingly different long-term outcomes. Transplantation 2013; 95(2): 267-74.

Dávila FA, Luna RD, Rey DAP. Analysis of post-transplant renal graft survival. Rev Colomb Nefrol 2015; 2(2): 95-100.

Campbell SB, Hothersall E, Preston J, Brown AM, Hawley CM, Wall D, et al. Frequency and severity of acute rejection in live- versus cadaveric-donor renal transplants. Transplantation 2003; 76(10): 1452-7.

Morales JM, Marcén R, del Castillo D, Andres A, Gonzalez-Molina M, Oppenheimer F, et al. Risk factors for graft loss and mortality after renal transplantation according to recipient age: a prospective multicentre study. Nephrol Dial Transplant 2012; 27 Suppl 4: iv39-46. doi: 10.1093/ndt/gfs544.

Noppakun K, Cosio FG, Dean PG, Taler SJ, Wauters R, Grande JP. Living donor age and kidney transplant outcomes. Am J Transplant 2011; 11(6): 1279-86.

Bodro M, Sanclemente G, Lipperheide I, Allali M, Marco F, Bosch J, et al. Impact of urinary tract infections on short-term kidney graft outcome. Clin Microbiol Infect 2015; 21(12): 1104.e1-8. doi: 10.1016/j.cmi.2015.07.019.

Gołębiewska JE, Dębska-Ślizień A, Rutkowski B. Urinary tract infections during the first year after renal transplantation: one center's experience and a review of the literature. Clin Transplant 2014; 28(11): 1263-70.

Published
2019/08/08
Section
Original article