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Abstract

Objectives: Renal allograft function and graft survival depends on many factors, including the source of the graft, immunologic matching between donor and recipient, incidence of acute rejection, and recurrence of the original kidney disease. This work aimed to evaluate the effects of the original kidney disease on patient and graft survival. Materials and Methods: This was a retrospective, single-center study that included 2189 kidney transplant recipients who were transplanted at The Urology and Nephrology Centre, Mansoura University, between 1976 and 2010. Of 2189 recipients, 1350 patients with unknown original kidney disease were excluded, with the remaining 839 patients divided into 4 groups according to their original kidney disease. Results: We found pretransplant dialysis and blood transfusion to be statistically significant among the 4 groups. Regarding induction immunosuppressive therapy, a statistical significance was found between the 4 groups regarding the presence and type of induction therapy, with no statistical significance regarding the type of maintenance immunosuppression. There was no statistical significance between the 4 groups regarding the incidence of acute and chronic rejection. We also found recurrence of original kidney disease to be statistically significant in the 4 groups, particularly in the group that included patients with glomerular disease, where the highest rate of recurrence was reported in patients with focal segmental glomerulosclerosis and membranop roliferative glomerulonephritis, and patient and graft survival was also statistically significant. Conclusions: The original kidney disease has an effect on renal allograft function and graft and patient survival.

A Scoping Review of Kidney Transplantation in Africa: How Far have We Come?

“…This represents 39.44% of all patients in these studies. Only Mashaly et al [17] distinguished between acute and chronic rejections (353 vs 197). Seven (7) episodes of delayed graft function were recorded (Pontin et al [32], Elsayed et al [33]).…”

“…In the postoperative period, there were 434 cases of acute tubular necrosis across 6 studies [17,18,23,26,36,43], and a total of 2248 post-op infections were recorded in 11 studies [15, 17-19, 23, 25-27, 33, 41, 43], totalling 11.36% of all patients in the studies reviewed. Bacterial infections were seen in 30.56% of all patients, which were the most significant cause of post-op infection of known cause, with viral infections (seen in 13.56% of patients) and tuberculosis (in 4.75% of patients) making up the rest.…”

Recurrence of primary glomerulonephritis: Review of the current evidence

“…It was assumed that 18%-22% of the death-censored kidney allograft losses was attributed to allograft GN ( de novo and recurrent)[ 7 ], the second most common cause of death-censored graft losses[ 18 ] and third most prevalent cause of uncensored graft losses[ 9 , 16 ]. However, Mashaly et al[ 19 ] observed that the best allograft survival of kidney transplantation was noted in recipients whose end stage renal failure was due to polycystic kidney disease followed by those who had urologic disease and then those who had GN as the cause of renal failure. The recurrent GN disease has a wide variety of drawbacks deranging allograft function, which made it occupy the third most common etiology of allograft loss after death with a functioning graft and chronic allograft glomerulopathy, an assumption that was agreed by Fairhead and Knoll[ 20 ] (2010) who declared that the recurrent GN disease is a major determinant of the long term graft survival (Figure 1 ).…”

“…It can recur immediately post-transplantation, or recur lately, where its diagnosis is usually masked by the secondary FSGS resulting from the reduced total nephron mass, or due to other causes, e.g ., iatrogenic[ 20 , 44 ]. Of all causes of the FSGN, “genetic” subtype showed the least incidence of recurrence[ 19 , 45 , 46 ]. On the other hand, podocin mutations did not show a decreased risk of recurrence[ 45 ].…”