Renal transplantation: kidney transplant candidatesCharacteristics of hemodialysis patients who underwent renal transplantation in Tehran, Iran: a 10-year follow-up study
Section snippets
Patients and methods
Of 242 HD patients admitted in one private and one university hemodialysis center from 1992 to 2002, 74 (36%) were clinically, socially, and economically eligible for renal transplantation. Clinically, these patients had no medical and surgical contraindications and no evidence of malignancy. There was no active infection, and HIVab, HCVab, and HBsAg were negative. Socially, they had no serious mental problems to reduce compliance, and economically they could afford to purchase the drugs that
Results
The mean age of the patients was 35.1 ± 12.7 (range 12 to 65 years) (Fig 1). The male-to-female ratio was 1.6:1. All donors were living and 96% were unrelated. Mean age was 29 years in donors and 80% were men. No HLA typing data were available, but histocompatibility (panel reactivity and WBC crossmatching) was performed. The mean duration of hemodialysis was 20.2 ± 20 months (Fig 2). The foremost underlying disease was hypertension (38.36%) (Fig 3), and 94.7% had a first and 5.3% a second
Discussion
In general, immunologic and nonimmunologic factors influence graft survival. Chronic nephropathy and patient death with functioning graft are predominant causes for loss of implant. In the first year of transplantation, patient death due to cardiovasculopathy is the most frequent cause of graft loss. In the second year, the cause of graft loss is chronic nephropathy causing death. Acute tubular necrosis and acute rejection are two important factors that can influence the evolution toward the
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