Amgad E. El-Agroudy, Mohamed A. Bakr, Nabil A. Hassan, Amani M. Ismail, Bedeir Ali El-Dein, Ahmed B. Shehab El-Dein, Mohamed A. Ghoneim
Urology and Nephrology Center, University of Mansoura, Mansoura, Egypt.
We report here on a 62 renal transplant recipients who survived with a functioning graft for more than 15 years (range 15-24 years). They included 43 males and 19 females, with a mean age at transplantation of 27.5± 6.6 yrs (range 9-43 yrs), and a mean donor age of 30± 8.6 yrs. The donor source was 8 parents, 49 siblings and 5 unrelated. Twenty-nine patients were cyclosporine (CsA) treated, while 33 patients were primarily immunosuppressed by steroids and azathioprine. Acute rejection episodes occurred in 40 patients (64.3%), out of them 19 patients experienced two or more acute rejection episodes. Comparative studies between the long-term and short-term (n= 82) survivors during the same observation period revealed that the recipient age, donor age, HLA-DR matching, pre and post transplantation hypertension are significant risk factors (P<0.05): Currently, forty-six (74.2%) of the 62 long-term survivors are still living with a functioning graft, 11 living on dialysis, and 5 died. We concluded that renal transplantation even in its earliest years and despite the numerous complications have provided 15 or more years of near normal life to patients with end stage renal disease.