Renal Transplant Experience in a Tertiary Care Center in Saudi Arabia: A Retrospective Cohort Study

Abstract

Background: Data on outcomes of renal transplantation in the Kingdom of Saudi Arabia (KSA) is limited. We describe renal transplant experience in one of the largest referral centers for renal transplants in KSA.Methods: This is a retrospective cohort study of patients who underwent kidney transplantation at King Abdulaziz Medical City (KAMC) from January 2016 to July 31, 2019, with at least one year of follow-up posttransplantation.Results: One hundred ninety-four individuals were identified and included in the analysis. The mean age of the renal transplant cohort was 45 years with an average pre-transplant body mass index of 26.1 kg/m 2 . The most common comorbidities were hypertension (77.3%) and diabetes mellitus (34.5%). The most common etiology of end-stage kidney disease (ESKD) was unknown (49.0%) followed by Lupus nephropathy (16.0%). Central venous catheters were the predominant dialysis access (56.2%). Living-related kidney donation was the commonest source of kidney transplantation (61.3%), followed by deceased donor renal transplantation (22.7%). Anti-thymocytes globulin (ATG) was the predominant induction agent (57.7%) and nearly all patients received tacrolimus-based maintenance immunosuppression. Mean serum creatinine at the time of discharge was 109 umol/l. Delayed graft function was observed in 6.7% of our patients. The most common medical complications were urinary tract infection (26.3%). Post-transplant surgical complications occurred at a low rate.Conclusion: Our study demonstrated a successful renal transplant experience among a relatively healthy cohort and identifies potential gaps, particularly the high rate of central venous catheters, the frequent lack of clear etiology of ESKD, the low rate of pre-emptive transplant, and deceased donors. Further studies are needed to evaluate and close these gaps.

Pseudoaneurysm and Renal Artery Stenosis Post-renal Transplant: A Rare Presentation

“…It is estimated to affect 9,892 per 100,000 people in Saudi Arabia. Renal transplantation is an ideal treatment strategy for patients with endstage kidney disease [9,10]. Our patient's transplant was a living-related donation.…”

A Three-Year Experience With Overseas Kidney Transplantation in a Tertiary Transplant Center in Saudi Arabia

“…Living-related donors were the main source of kidney grafts as per our local experience. Moreover, only one in five transplanted patients received their kidney from cadaveric donors [ 13 ]. Hence, it is likely that patients who are unable to find a suitable living donor may travel overseas for transplantation via a non-related living donor.…”

“…We compared the baseline characteristics and outcomes of the cohort that underwent kidney transplantation overseas to a cohort of patients that were transplanted locally within the same period and who also had at least one year of follow-up post-transplantation. The details of the locally transplanted cohort were published separately earlier this year [ 13 ]. Due to better human leukocyte antigen (HLA) matching between the first-degree relatives, we anticipated that the graft-related outcomes were likely to be superior in our locally transplanted group, given that most of them received living-related kidney [ 13 ].…”

“…The details of the locally transplanted cohort were published separately earlier this year [ 13 ]. Due to better human leukocyte antigen (HLA) matching between the first-degree relatives, we anticipated that the graft-related outcomes were likely to be superior in our locally transplanted group, given that most of them received living-related kidney [ 13 ]. To diminish the HLA influence, we performed a subgroup analysis where we restricted the locally transplanted cohort to unrelated donors, whether deceased or living, and repeated the comparison to confirm if differences in graft-related outcomes remained superior in the locally transplanted group.…”

Establishing the Kidney dIsease in the National guarD (KIND) registry: an opportunity for epidemiological and clinical research in Saudi Arabia

“…However, despite being one of the most advanced medical systems in the Middle East, SA lacks a national kidney disease registry, including the different types of kidney disease. Instead, local observational studies have been the primary source of context-specific information on the different types of kidney disease [ 25 – 27 ]. Some of the observational studies suggested that the prevalence of kidney diseases in SA may differ from the other countries [ 24 ].…”