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Kidney transplantation (KT) offers better survival over dialysis in patients with end stage kidney disease (ESKD). Reports of allograft outcomes after KT from India is limited. We studied the allograft outcomes after kidney transplantation at our hospital.
All patients who underwent KT at our hospital during the years 2012-2022 were included. The demographic data, transplant operation details, details of graft loss and death were recorded from the KT case file and hospital discharge summaries. Graft survival was calculated from the date of transplant to the date of initiation of dialysis. Patient survival was calculated from the date of transplant to the date of death of the KT Recipient (KTR). Continuous variables were summarized by mean with standard deviation, and median with interquartile range. Kaplan-Meier curves were constructed to estimate the survival. All analyses were performed with SPSS version 22.
During the study period, 266 ESKD patients (172 from living donors, 94 from deceased donors) underwent KT at our hospital. The 1-year and 5-years graft survival were 86 and 63 percent respectively. When death was censored, the 1-year and 5-years graft survival were 93 and 77 percent respectively. The 1-year and 5-years patient survival were 90 and 73 percent respectively. Ninety-nine grafts were lost during the study period and 36 among them were lost within the first post-transplant year. Death with a functioning graft (51.5%) and chronic antibody mediated rejection (15.1%) were the main reasons for graft failure. Infections (90%) were the leading cause of death in patients dying with a functional graft. There was no difference in graft survival with respect to the type of donor (living vs deceased), HLA match (any match vs no match) and induction (any induction vs no induction).
Premature deaths caused by infections was the principal factor limiting graft survival at our centre. Strategies to reduce infectious complications may improve graft survival.