The Experience and Outcome of Renal Transplantation in Yemen

Abstract

Access to renal transplantation in the developing world remains limited It remains the treatment of choice for endstage kidney disease. This procedure not only improves quality of life, but also markedly increases patients' survival rates. Therefore, this study aimed to evaluate clinical outcomes of renal transplants in our center and to compare the outcomes between the patients who received induction therapy and those patients without such induction. It was a retrospective study conducted at Al Thawra General Hospital, Sana'a on 154 patients. Data were collected on all patients who underwent a renal transplant from 2004 to t 2015. Analyses were performed to assess baseline characteristics, graft and patient survival, as well as the outcomes of patients who given induction therapy. A total of 154 renal transplants were carried out at Al Thawra center. The mean age of patients was 32.42 ± 10.4 years (rang 14-66) and the male sex was predominant accounting for 72.7%. There were 93.5% of patients on dialysis and the dialysis time was ≥ 3 years in 72%. The major causes of end-stage kidney disease (ESKD) were chronic pyelonephritis (77.9%), hypertension (13%), glomerulonephritis (3.9%) and diabetes mellitus (2.4%). During the first year following renal transplants, 6 patients (3.9%) complicated by acute rejection episodes that did not reach statistical significance (P > 0.05). It is found that the mortality rate during the 1 st , 5 th , and 10 th years was 1.9%, 9% and 14.9%respectively and the infectious conditions were the most frequent cause of death (13%) followed by cardiovascular events (3.9%) and others (2.5%). Although, the process of renal transplants in Yemen started slowly with the initial support and cooperation of the Egyptians' transplant surgeons, the overall outcomes are satisfactory and comparable to the universal reports.