Cadaveric renal transplantation: the Chennai experience

Area of Science:

• Nephrology
• Transplant Surgery
• Public Health

Background:

• Organ transplantation is a vital medical advancement, yet its accessibility in India is limited.
• End-stage renal failure affects over 152,000 individuals annually in India, necessitating renal transplantation.
• The Transplantation of Human Organs Act (1994) legalized cadaveric donation and prohibited organ commerce.

Purpose of the Study:

• To evaluate the outcomes of cadaveric kidney transplantation at Sri Ramachandra Medical College.
• To identify challenges and prerequisites for successful organ donation and transplantation in India.

Main Methods:

• Retrospective analysis of 68 cadaveric kidney transplants performed between 1995 and subsequent years.
• Data collection on donor characteristics, cold ischemia time, graft function, rejection episodes, and patient/graft survival.
• Assessment of factors influencing transplantation rates and outcomes.

Main Results:

• Mean donor age was 36 years; mean cold ischemia time was 5.6 hours.
• 50% immediate graft function; 17.6% required post-operative dialysis.
• 1-year patient survival was 88.2%, and graft survival was 73.5%. 5-year survival rates were 61.7% and 58.8%, respectively.
• Acute rejection episodes occurred in 26.4% of patients.

Conclusions:

• Cadaveric kidney transplantation outcomes in India show promising survival rates but highlight a low overall transplantation rate.
• Enhancing organ donation necessitates improved public perception, timely brain death identification, prompt consent, and robust hospital infrastructure.