Results of more than 1400 kidney transplants from a living related donor performed at the State Institution "RSSPMCS named after Academician V.Vakhidov", Uzbekistan
Dildora Komilova1, Zokhidjon Matkarimov1, Fazlitdin Bakhritdinov1, Jasur Sobirov1, Marguba Azimova1, Muzaffar Rustamov1, Jasur Urinov1, Akrom Akhmedov1, Nigina Elmurodova1, Ismoil Rustamov1.
1Kidney transplantation and rehabilitation, Republican specialized scientific and practical medical center of surgery named after academician V., Tashkent, Uzbekistan
Introduction: Kidney transplantation (KT) from a living related donor (LRD) is one of effective alternative treatment methods for end-stage chronic renal failure (CRF), which frees the patient from expensive, long-term dialysis procedures that adversely affect the general condition of the body. Today, methods of renal replacement therapy (RRT), such as programmed hemodialysis, as well as kidney transplantation, can radically change the prognosis for patients with uremia. In Uzbekistan, according to the latest data, the incidence of chronic renal failure is approximately more than 700 people per 1 million population (Sabirov M.A.et al.,2021).
Purpose of the work: Performing the evaluation of surgical activity, tactics, and postoperative results of patients who have undergone KT from LRD.
Materials and methods: From 2010 to 2024 years in the departments of "Vascular Surgery and Kidney Transplantation", as well as "Kidney Transplantation and Rehabilitation" of the Republican specialized scientific and practical medical center of surgery named after academician V. Vakhidov performed more than 1400 kidney transplants from the LRD.
Results: A total of 230 (29.2%) complications were diagnosed in the early and immediate period after related KT, including the largest number of systemic complications, such as drug-induced toxic hepatitis (49 out of 789; 6.2%) and bronchopulmonary complications (39 out of 789; 4.9%), post-transplant persistent hyperglycemia (PTPH) (11 out of 789; 1.4%) and heart failure with a functioning transplant (10 out of 789; 1.3%), to varying degrees associated with side effects of immunosuppressive therapy.
In 98% of patients in the early postoperative period CRF symptoms disappeared. The level of plasma creatinine (reduction to 120 mkmol/l or less) on average normalized by 4.22±0.9 days. 1 month after transplantation, this indicator was 0.1±0.02 mmol/l, and the glomerular filtration rate was 85±5 ml/min 5 days after transplantation.
Conclusion: As a result of research it has been proven that currently, due to the shortage of cadaveric donor organs, transplantation from living donors is not only gaining greater success, but also in all criteria of survival and quality of life in the long-term period after transplantation is significantly superior to transplantation from cadaveric donors (The International Registry of Organ Donation and Transplantation (IRODaT). Clinical experience has demonstrated high survival rates of kidney transplants, which suggests that kidney transplantation from living related donors is the most effective method of treating patients with end-stage chronic renal failure. This is due not only to a greater degree of immunological compatibility of the related donor and recipient, but also largely due to a reduction in the time of cold ischemia, thereby reducing the severity of reperfusion injuries.
[1] Living related donor, kidney transplant, functioning transplant, immunosuppressive therapy, postoperative complications