INTRODUCTION :
Treatment option for Chronic Kidney Disease-Stage5 (CKD-stage5) patients
fall into three categories viz., Haemodialysis, Peritoneal dialysis and Renal
Transplantation. Many studies proved that the kidney transplantation is distinctly
superior and it is associated with reduced mortality and morbidity compared to
haemodialysis or peritoneal dialysis.
The renal donors are of three types viz. live related, live unrelated and
cadaver. Due to shortage organs and long waiting period in cadaver transplant
prevention of second or re transplant is more important. To improve the graft survival
identifying etiology of graft dysfunction or loss is more important. Once we identified
the etiology we have to evaluate for immunologic, nonimmunologic, modifiable, non
modifiable risk factors to improve the graft and patient survival.
METHODS :
All renal transplant recipients on regular follow up are included - September
2009 to march 2011. Those who died and those who are in irregular follow up during the period of
study are excluded from the study. All the patient having graft dysfunction underwent renal biopsy.
CONCLUSION :
According to Univariate analysis following conclusion were made
Tacrolimus gives a better graft survival than cyclosporine for both live
and cadaveric transplants.
Donor age has significant impact on long term graft survival; younger
the donor better the outcome.
With female donors the graft dysfunction is more, may be due to
difference in antigencity and smaller renal mass.
The Male recipients do worse than female recipients; probably due to
female recipients has higher degree of sensitization to HLA antigen.
Blood group, cross match results, day one urine output, First post
operative day creatinine, discharge creatinine are not having significant
association with cause graft dysfunction.
Delayed graft function has significant impact on long term graft survival
according to Univariate analysis.
Side of the kidney , number of blood vessels, post operative events are not
statistically significant to cause graft dysfunction