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2020, Number 2

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Rev Mex Traspl 2020; 9 (2)

Protocol adjusted to second level kidney transplant care living donor, experience in survival in an Instituto Mexicano del Seguro Social Center

Radilla-Ramos D, Rojas-Hernández G, Barajas-González S, Espinosa-Mercado L, Sandoval-Quintana JS

Language: Spanish
References: 19
Page: 56-63
PDF size: 242.45 Kb.


ABSTRACT

Introduction: End-stage renal failure (ESRD) is a large problem in Mexico. There is talk of a total population of around 174 thousand patients in 2016, however, to date, there is no precise information, since there is no centralized national registry of cases of kidney disease in Mexico. Kidney transplant is the replacement therapy of choice in most patients with ESRD. Material and methods: A retrospective-prospective longitudinal and observational study was carried out during the period from July 2014, the date of the first transplant, to December 2019. The physical and electronic clinical files of the patients were reviewed. We analyzed the survival of the graft and the patient with kidney transplant from living donor at 1, 3, 6, 12, 24, 36, 48 and 60 months (five years), using Kaplan-Meier actuarial survival curves. The results obtained were compared with those obtained in living donor of third level hospitals. Results: During the period, 65 living donor kidney transplants were performed, all primary transplants, 65% men (n = 42) and 23 women (35%), with an average age of 26.53 ± 8.08 (range 17-53). The patient’s overall survival was 98% at five years. Graft survival was 98% at two years and 94% at five years. Only four graft losses were reported: one due to arterial thrombosis, another due to chronic humoral rejection, one more due to chronic rejection due to lack of consumption of immunosuppressive drugs and the last due to death of the renal receptor, at 1, 26, 28 and 34 months, respectively. Conclusion: Our results show that the survival of the patient and the graft in a second level hospital are comparable with third level hospitals. The selection of patients in this type of medical units is important, due to the resources and the infrastructure that is available; therefore, working on patients with low immunological risk guarantees a better success rate in both survivals and consequently, a better quality of life.


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