Kidney transplantation achievements in Mongolia

Between August 2006 and August 2009, 33 patients with end-stage renal disease were the recipients of kidney transplantations. The donors were living related 29 operations with 4 recipients of 2 deceased donors following accidents with cardiac arrest controlled after permission by the next of kin. We used standard techniques for the donor and recipient operations. All recipients were prescribed 1 dose of alemtuzumab (Campath 1 H 20-30 mg), peroperatively preceded by 500 mg methylprednisolone. In 2 recipients, a second infusion of Campath 1 was administered on postoperative day 2. On postoperative day 3, we prescribed monotherapy with either cyclosporine (n=29) at a starting dose of 7 mg/kg body weight or tacrolimus (n=6) at a starting dose of 0.7 mg/kg body weight. With the exception of patients treated for an acute rejection episode, no patient received steroid therapy. There were 7 acute rejection episodes, which were treated with 3 consecutive daily doses of methylprednisolone (250 mg). The 1-year patient survival was 94% and 2-year graft survival, 84.8%. We concluded that the use of Campath 1 together with a non-steroid maintenance immunosuppressive regimen provided acceptable graft and patient survival in our developing country.