Öz
Introduction:
The aim of this study was to determine renal transplantation results that we performed in ourcenter.
Material- Methods:
A retrospective review of the results of renal transplantation between 1996 and 2006 was conducted.The evaluation was about both grafts and patients survival and immunologic, surgical complications in 1, 5, 10 years follow-up.
Results:
A total of 157 renal transplantation patients were included in the study.To 139 patients (89%) living related donor, and to 18 patients (11%) cadaveric renal transplantation was done. The mean age of the patients during the time of the operations was 30,4 years (range 14-60). The mean follow-up time was 55 months. In 1,5,10 years follow-up, the grafts survival rates of transplantations from living donors were 92%,80%,50%, and also the patients survival rates were 95%,90%,80% respectively. In 1,5 years follow-up, the graft survival rates of transplantations that we had done from cadavers were 89%,62% and the patients survival rates were 100%,87% respectively. Surgical complications developed in 43 patients, while in other 114 patients not. The most common surgical complications was lymphocele in 17 patients (10.8%) that was followed by ureterovesicalstenosis in 10 patients (6,4%), urinoma in 6 patients (3,8%), surgical site infection in 5 patients (3,2%), renal artery stenosis in 3 patients (1,9%), renal vein thrombosis in 2 patients (1,3%) respectively.
Conclusion:
We can prevent the harmful effects of surgical complications and rejections over the graft function and graft survival when we diagnose and treat them early.
Anahtar Kelimeler
Kaynakça
- 1. Murray JE, Barnes BA, Atkinson J. Fifth report of The Human Kidney Transplant Registry. Transplantation. 1967;5(4):752-74.
- 2. Karakayali H, Haberal M. The history and activities of transplantation in Turkey. Transplantation proceedings. 2005;37(7):2905-8.
- 3. Russell JD, Beecroft ML, Ludwin D, Churchill DN. The quality of life in renal transplantation--a prospective study. Transplantation. 1992;54(4):656-60.
- 4. Titiz İ. Renal Transplantasyona Pratik Yaklaşım. İkinci Baskı). 2004;1:11-100.
- 5. Cohen D VA. In: Lee Goldman AIS, editor. Goldman-Cecil Medicine. Treatment of irreversıble renal failure2020. p. 804-11.
- 6. Domínguez-Gil B. International figures on donation and transplantation 2018. In: Domínguez-Gil B, editor. Newsletter Transplant: The EDQM/Council of Europe 2018.
- 7. Moosa MR. Kidney transplantation in developing countries. Kidney Transplantation–Principles and Practice: Elsevier; 2014. p. 643-75.
- 8. Winterberg PD, Garro R. Long-Term Outcomes of Kidney Transplantation in Children. Pediatric Clinics. 2019;66(1):269-80.
- 9. Coemans M, Süsal C, Döhler B, Anglicheau D, Giral M, Bestard O, et al. Analyses of the short-and long-term graft survival after kidney transplantation in Europe between 1986 and 2015. Kidney international. 2018;94(5):964-73.
- 10. Goldfarb-Rumyantzev AS, Koford JK, Baird BC, Chelamcharla M, Habib AN, Wang B-J, et al. Role of socioeconomic status in kidney transplant outcome. Clinical Journal of the American Society of Nephrology. 2006;1(2):313-22.
- 11. Shah S, Collett D, Johnson R, Thuraisingham RC, Raftery MJ, Rudge CJ, et al. Long-term graft outcome with mycophenolate mofetil and azathioprine: A paired kidney analysis. Transplantation. 2006;82(12):1634-9.
- 12. Clayton PA, McDonald SP, Chapman JR, Chadban SJ. Mycophenolate versus azathioprine for kidney transplantation: a 15-year follow-up of a randomized trial. Transplantation. 2012;94(2):152-8.
- 13. Takemoto SK, Terasaki PI, Gjertson DW, Cecka JM. Twelve years' experience with national sharing of HLA-matched cadaveric kidneys for transplantation. New England Journal of Medicine. 2000;343(15):1078-84.
- 14. Baumeister S, Kleist C, Döhler B, Bickert B, Germann G, Opelz G. Risks of allogeneic hand transplantation. Microsurgery: Official Journal of the International Microsurgical Society and the European Federation of Societies for Microsurgery. 2004;24(2):98-103.
- 15. Foroutan F, Friesen EL, Clark KE, Motaghi S, Zyla R, Lee Y, et al. Risk Factors for 1-Year Graft Loss After Kidney Transplantation: Systematic Review and Meta-Analysis. Clinical Journal of the American Society of Nephrology. 2019;14(11):1642-50.
- 16. Park Y-H, Min S, Lee J, Lee H, Jung W, Lee J, et al. Risk factors on graft survival of living donor kidney transplantation. Transplantation proceedings. 2004;36(7):2023-5.
- 17. Clayton PA, McDonald SP, Russ GR, Chadban SJ. Long-Term Outcomes after Acute Rejection in Kidney Transplant Recipients: An ANZDATA Analysis. Journal of the American Society of Nephrology. 2019;30(9):1697-707.
- 18. Koçak T, Nane I, Ander H, Ziylan O, Oktar T, Ozsoy C. Urological and surgical complications in 362 consecutive living related donor kidney transplantations. Urologia internationalis. 2004;72(3):252-6.
- 19. Faba OR, Boissier R, Budde K, Figueiredo A, Taylor CF, Hevia V, et al. European association of urology guidelines on renal transplantation: Update 2018. European urology focus. 2018;4(2):208-15.
- 20. Ziȩtek Z, Sulikowski T, Tejchman K, Sieńko J, Janeczek M, Iwan-Ziȩtek I, et al. Lymphocele after kidney transplantation. Transplantation proceedings. 2007;39(9):2744-7.
- 21. Golriz M, Klauss M, Zeier M, Mehrabi A. Prevention and management of lymphocele formation following kidney transplantation. Transplantation Reviews. 2017;31(2):100-5.
- 22. Dimitroulis D, Bokos J, Zavos G, Nikiteas N, Karidis N, Katsaronis P, et al. Vascular complications in renal transplantation: a single-center experience in 1367 renal transplantations and review of the literature. Transplantation proceedings. 2009;41(5):1609-14.
Öz
Amaç : Kliniğimizde yapılan Renal transplantasyon sonuçlarını incelemek ve litaretüre kazandırmak
Materyal ve metod: Bu çalışmada 1996 ile 2006 tarihleri arasında kliniğinimizde yapılan renal transplantasyon hastalarının sonuçları değerlendirildi. Renal transplantasyon yapılan hastaların sonuçları; 1,5,10 yıllık greft ve hasta sağkalımı, immunolojik ve cerrahi komplikasyonlar yönünden incelendi.
Bulgular: Toplam hasta sayısı 157 olup 18(%11)’i kadavradan 139 (%89)’u canlıdan elde edilen böbrekler ile renal transplantasyon yapılmıştır. Yüzonüçü erkek 44’ü kadın olup yaş ortalaması 30.49.8 yıldır. Renal transplantasyon yapılan en genç hasta 14 yaşında iken en yaşlısı 60 yaşındadır. Ortalama takip süresi 55 aydır. Canlı donörlerden yapılan renal transplantasyonda 1,5,10 yıllık greft sağkalım oranları sırasıyla %92,%80,%50 olup 1,5,10 yıllık hasta sağkalım oranları sırasıyla %95,%90,%80dir.Kadavradan kaynaklı böbrekler ile yapılan renal transplantasyonda 1,5 yıllık greft sağkalım oranları sırasıyla %89, %62 olup 1 ve 5 yıllık hasta sağkalım oranları sırası ile %100 ve %87 dir. Hastaların 43’ünde cerrahi komplikasyon gelişirken 114 hastada gelişmedi. Cerrahi komplikasyon içinde 17 hasta (%10,8) ile lenfosel ensık görüleni olup bunu sıklık sırasına göre 10 hasta (%6,4) üreterovezikal darlık, 6 hasta (%3,8) ürinom, 5 hasta (%3,2) yara yeri enfeksiyonu, 3 hasta (%1,9) renal arter stenozu, 2 hasta (%1,3) renal ven trombozu takip etmektedir.
Sonuç: Renal transplantasyon sonrası cerrahi komplikasyonların ve rejeksiyonların erken tanı ve tedavisi ile, greft fonksiyonu ve greft sağkalım süresi üzerindeki olumsuz etkiler önlenebilir.
Anahtar Kelimeler
Kaynakça
- 1. Murray JE, Barnes BA, Atkinson J. Fifth report of The Human Kidney Transplant Registry. Transplantation. 1967;5(4):752-74.
- 2. Karakayali H, Haberal M. The history and activities of transplantation in Turkey. Transplantation proceedings. 2005;37(7):2905-8.
- 3. Russell JD, Beecroft ML, Ludwin D, Churchill DN. The quality of life in renal transplantation--a prospective study. Transplantation. 1992;54(4):656-60.
- 4. Titiz İ. Renal Transplantasyona Pratik Yaklaşım. İkinci Baskı). 2004;1:11-100.
- 5. Cohen D VA. In: Lee Goldman AIS, editor. Goldman-Cecil Medicine. Treatment of irreversıble renal failure2020. p. 804-11.
- 6. Domínguez-Gil B. International figures on donation and transplantation 2018. In: Domínguez-Gil B, editor. Newsletter Transplant: The EDQM/Council of Europe 2018.
- 7. Moosa MR. Kidney transplantation in developing countries. Kidney Transplantation–Principles and Practice: Elsevier; 2014. p. 643-75.
- 8. Winterberg PD, Garro R. Long-Term Outcomes of Kidney Transplantation in Children. Pediatric Clinics. 2019;66(1):269-80.
- 9. Coemans M, Süsal C, Döhler B, Anglicheau D, Giral M, Bestard O, et al. Analyses of the short-and long-term graft survival after kidney transplantation in Europe between 1986 and 2015. Kidney international. 2018;94(5):964-73.
- 10. Goldfarb-Rumyantzev AS, Koford JK, Baird BC, Chelamcharla M, Habib AN, Wang B-J, et al. Role of socioeconomic status in kidney transplant outcome. Clinical Journal of the American Society of Nephrology. 2006;1(2):313-22.
- 11. Shah S, Collett D, Johnson R, Thuraisingham RC, Raftery MJ, Rudge CJ, et al. Long-term graft outcome with mycophenolate mofetil and azathioprine: A paired kidney analysis. Transplantation. 2006;82(12):1634-9.
- 12. Clayton PA, McDonald SP, Chapman JR, Chadban SJ. Mycophenolate versus azathioprine for kidney transplantation: a 15-year follow-up of a randomized trial. Transplantation. 2012;94(2):152-8.
- 13. Takemoto SK, Terasaki PI, Gjertson DW, Cecka JM. Twelve years' experience with national sharing of HLA-matched cadaveric kidneys for transplantation. New England Journal of Medicine. 2000;343(15):1078-84.
- 14. Baumeister S, Kleist C, Döhler B, Bickert B, Germann G, Opelz G. Risks of allogeneic hand transplantation. Microsurgery: Official Journal of the International Microsurgical Society and the European Federation of Societies for Microsurgery. 2004;24(2):98-103.
- 15. Foroutan F, Friesen EL, Clark KE, Motaghi S, Zyla R, Lee Y, et al. Risk Factors for 1-Year Graft Loss After Kidney Transplantation: Systematic Review and Meta-Analysis. Clinical Journal of the American Society of Nephrology. 2019;14(11):1642-50.
- 16. Park Y-H, Min S, Lee J, Lee H, Jung W, Lee J, et al. Risk factors on graft survival of living donor kidney transplantation. Transplantation proceedings. 2004;36(7):2023-5.
- 17. Clayton PA, McDonald SP, Russ GR, Chadban SJ. Long-Term Outcomes after Acute Rejection in Kidney Transplant Recipients: An ANZDATA Analysis. Journal of the American Society of Nephrology. 2019;30(9):1697-707.
- 18. Koçak T, Nane I, Ander H, Ziylan O, Oktar T, Ozsoy C. Urological and surgical complications in 362 consecutive living related donor kidney transplantations. Urologia internationalis. 2004;72(3):252-6.
- 19. Faba OR, Boissier R, Budde K, Figueiredo A, Taylor CF, Hevia V, et al. European association of urology guidelines on renal transplantation: Update 2018. European urology focus. 2018;4(2):208-15.
- 20. Ziȩtek Z, Sulikowski T, Tejchman K, Sieńko J, Janeczek M, Iwan-Ziȩtek I, et al. Lymphocele after kidney transplantation. Transplantation proceedings. 2007;39(9):2744-7.
- 21. Golriz M, Klauss M, Zeier M, Mehrabi A. Prevention and management of lymphocele formation following kidney transplantation. Transplantation Reviews. 2017;31(2):100-5.
- 22. Dimitroulis D, Bokos J, Zavos G, Nikiteas N, Karidis N, Katsaronis P, et al. Vascular complications in renal transplantation: a single-center experience in 1367 renal transplantations and review of the literature. Transplantation proceedings. 2009;41(5):1609-14.
Ayrıntılar
| Birincil Dil | Türkçe |
|---|---|
| Konular | Klinik Tıp Bilimleri |
| Bölüm | Makaleler |
| Yazarlar | |
| Yayımlanma Tarihi | 27 Haziran 2020 |
| Gönderilme Tarihi | 27 Mayıs 2020 |
| Yayımlandığı Sayı | Yıl 2020 Cilt: 3 Sayı: 2 |