بررسی مقایسه‌ای نتایج پیوند کلیه در بیمارستان شهید هاشمی‌نژاد در سال‌های 1383-1374 با سال‌های 1374-1365

    Background & Aim: A total number of 1760 renal transplantations (Tx) have been performed at Hashemi Nejad Hospital since 1986. The results of the first 1350 consecutive renal Txs were previously reported in Clinical Transplants (2000). During the recent years (1996-2005),the ratio of renal Tx from living unrelated donor (LURD) to living related donor (LRD) has markedly increased and majority of renal Tx recipients have received Mycophenolate Mofetil (MMF) instead of Azathioprine (Aza) in their immunosuppressive regimen. This study was carried out to evaluate the short and long- term results of kidney transplantation in Hashemi Nejad Hospital 1996-2005 (group B) and compare them with the results during 1986-1996 (group A). Patients & Methods: On the basis of transplantation date, patients were divided into two groups: Group A(1986-1996) consisted of 863 renal Tx recipients. 572(66.3%) were male and 291 (33.7%) were female with mean age of 33.4±10.9 years. 365 (42.4%) of the renal allografts were from LRDs and the rest were from LURDs. The majority of patients were on Cyclosporine (CsA), Aza and Prednisolone. Group B(1996-2005) consisted of 878 renal Tx recipients. 527(60%) were male and 351(40%) were female with mean age of 38±12 years. 66(7.5%)of renal allografts were from LRDs and remaining 812 (92.5%) were from LURDs.613 recipients received MMF. The statistical analysis was done via SPSS 9.1. t-test, chi-square and logistic regression analysis were used to compare the groups. Patient and graft survival and their risk factors were estimated by Kaplan- Meier method and Log rank test. Results: The findings showed that the patient survival rates were not significantly different in two groups (P=0.28). The overall graft survival rates were 90.76%, 74.7% and 61.6% at one, 5 and 8 years after Tx respectively. These data showed a statistically significant improvement in graft survival rates in comparison with similar data of years 1986-1996 (85.02%, 65.32% and 54.6% P<0.001). Among risk factors of age and gender of donor and recipient, date of Tx, related vs. unrelated Tx, HLA and immunosuppressive regimen, graft survival rates in patients who were on MMF were significantly better compared to patients who were on Aza (P<0.05). Conclusion: Improvement of graft survival rates in 1996-2005 in comparison with 1986-1996 report showed the beneficial effect of MMF, which compensated for the adverse effect of HLA mismatching (higher percent of LURD) in kidney graft survival.