Survival analysis of renal transplant recipients in Kermanshah province(1989 – 2001)

Background& Objective:  The prevalence and annual incidence of end stage renal disease  among 60 million Iranians is about 15000 and 3175 (53 patients per million), respectively. The first renal transplantation was performed in Shiraz, Iran in 1967. Iran has the most successful renal transplant program in the Middle East  region. The renal transplant activity of the country has reached 24 renal transplants per million per year. The number of transplantation centers and transplantations have increased from 2 and 95 in 1986  to 21 and 951 in 1997, respectively. The kidney transplantation (KT) was started in Kermanshah , in 1989. Conflicting Survival rates of  KT in Iran and world has been reported and there is no report from Kermanshah. In the present study, patient and graft survival rates of  KT  are reported.

 Materials and methods:  This study was done on 712 kidney transplant recipients  in Kermanshah province and include  all KT recipients from 1989 to 2001.  The variables that were analyzed include age, sex , dialysis time , and primary disease.  Patient and graft survivals were calculated using Kaplan Meier method. Survival curves were compared with Log rank test. Comparison of data were done with  Student’s t  test , chi square, and Fisher’s exact test.

Results: Patient survival for recipients with a  living unrelated donor ( LURD ) at 1 , 3 , and 10 years were 89.4 , 82.4 , and 61.4 months, respectively,  and for recipients with a living related donor (LRD )  100 , 97.3 , and 72. 6 percent.  Graft survival for recipients with a  living unrelated donor  at 1 , 3 , and 10 years were 85.6 , 77.2 , and 33.3 respectively,  and for recipients with a living related donor 97.4 , 92.3 , and 60.6 percent Ranks were higher in recipients with a related donor. (Log rank , P=0.0056).

Discussion and Conclusions:  Graft and patient survival rates obtained from our study are comparable to the reported results from other units in Iran and some Eastern European countries , higher than most countries of the former Soviet bloc , and less than USA , Japan and Western countries.