Why does kidney allograft fail? A long-term single-center experience

Area of Science:

• Nephrology
• Transplantation Immunology
• Clinical Medicine

Background:

• Renal transplantation is a vital treatment for end-stage renal disease.
• Understanding long-term allograft survival is crucial for patient management.
• Bahraini renal transplant recipients' outcomes require specific investigation.

Purpose of the Study:

• To characterize Bahraini renal transplant recipients with functioning allografts for over 10 years.
• To identify predictors of long-term graft survival in this population.
• To evaluate outcomes despite early transplantation challenges.

Main Methods:

• Retrospective review of medical records for 78 renal transplant recipients (1982-1999).
• Analysis of patient demographics, graft sources, immunosuppression regimens, and rejection episodes.
• Comparison of characteristics between long-term functioning graft recipients and graft failure groups.

Main Results:

• 56 patients (72%) maintained functioning allografts for 10-30 years.
• Mean age at transplantation was 33.6 years; 75% received grafts from living related donors.
• Independent predictors of long-term survival included late acute rejection, chronic allograft damage, post-transplant hypertension, and serum creatinine at one year.

Conclusions:

• Renal transplantation offers over a decade of near-normal life for end-stage renal disease patients, even with early-era complications.
• Effective management of acute rejection and chronic allograft damage is vital for sustained graft function.
• Post-transplant hypertension and early serum creatinine levels are critical indicators for long-term renal allograft success.