Long-Term Clinical Outcomes and Dynamics of Immunosuppressive Therapy in Kidney Transplant Recipients in Uzbekistan:...

This study evaluated the long -term clinical outcomes and dynamics of immunosuppressive therapy in kidney transplant recipients in Uzbekistan, which was compared with international data.

This retrospective multicenter cohort study included 3437 kidney transplant recipients. Data were obtained from the national transplant registry. Follow -up ranged from 1 to 30 years. Clinical outcomes, graft survival, recipient survival, and immunosuppressive therapy parameters were analyzed. Repeated -measures analysis of variance and life -table analysis were used for statistical evaluation.

A gradual reduction in tacrolimus dose was observed from 6.68 mg /day at year 1 to 5.58 mg /day at year 10, accompanied by a decrease in mean blood concentration from 8.28 to 6.55 ng /mL. Mycophenolate mofetil dosing decreased significantly over time (P < .001 ), whereas mycophenolic acid dosing remained stable (P > .05 ). The incidence of graft loss requiring return to hemodialysis was 2.88 %. A biphasic pattern of graft loss was identified, with peaks within the first 3 years and after 10 years posttransplant. Recipient survival rates were 98.8 % at 1 year and 96.9 % at 10 years.

Kidney transplantation in Uzbekistan demonstrates favorable long -term outcomes comparable to international benchmarks. Immunosuppressive therapy shows a trend toward controlled minimization. The identified biphasic risk of graft loss highlights the importance of long -term monitoring and individualized management strategies.