Renal transplant in Nepal: medical complications in first three months

Abstract

Introduction: A successful renal transplant program was started in Nepal on August 8, 2008 in Tribhuvan University Teaching Hospital; and since then more than 200 live renal transplants have been done in our center.

Methods: A prospective analysis was done of 50 consecutive renal transplant recipients (performed from June 29, 2011 to May 16, 2012), with a minimum of 3 months of follow up. All recipients were on tacrolimus, mycophenolate mofetil, and steroids. The outcomes of the study were medical complications that occurred within the study period.

Results: The mean age of the recipients and donors were 36.0 ± 1.1 (range 15-59) and 48.3 ± 1.1 (range 22-65) years respectively. The fatal complications were one case each of hospital acquired pneumonia leading to sepsis, delayed graft function secondary to acute tubular necrosis, and community acquired pneumonia. The most common non-fatal infection in first month post-transplant was urinary tract infection, 24 episodes were identified in 20 recipients (40%). In 1 to 3 month post-transplant also, urinary tract infection was the most common non-fatal infection, 6 episodes occurred in 5 recipients (10%). 6 episodes of biopsy proven acute rejection occurred in 6 recipients (12%). Delayed graft function was observed in 2 patients (4%). New onset diabetes after transplant occurred in 6 patients (12%).

Conclusion: The most common medical complication in first three months post-transplant was urinary tract infection, followed by acute rejection, new onset diabetes mellitus after transplant and delayed graft function.