Renal transplantation in Nepal: beginning of a new era!

Aim To assess the first year outcomes in terms of patient survival rate, graft survival rate and secondary outcomes after starting the first live related renal transplant in Tribhuvan University Teaching Hospital, Nepal. Methods A retrospective analysis was done of the first 70 renal transplants, who have completed a minimum of 1 year of follow up. All recipients were on Tacrolimus, Mycophenolate Mofetil, and corticosteroids. Results Patient and graft survival rate at the end of one year was 94.3% (95% confidence interval (CI) 86.2–97.8). Mean serum creatinine and estimated glomerular filtration rate at 1 year was 115 ± 25 μmol/L (range 63–192) and 66 ± 15 mL/min per 1.73 m2 (range 37–102) respectively. Twenty-two episodes of biopsy proven acute rejection occurred in 18 recipients (25.7%). Three patients (4.2%) had acute tubular necrosis; however, only one (1.4%) had delayed graft function. One patient, with focal segmental glomerulosclerosis had recurrence of native kidney disease. Thirty-two episodes of urinary tract infection were observed in 22 recipients (31.4%), and Escherichia coli was the most commonly isolated organism, 17 (53.1%) out of 32 episodes. New onset diabetes mellitus after transplant occurred in 16 recipients (22.8%). Conclusion One-year patient survival, graft survival and secondary outcomes of our kidney transplant recipients, with our limited facilities, were within acceptable limits.