Aim: To summarize our single – center experience in renal transplantation (RT), analyze the trends and review the influence of these trends on outcomes of RTx for further evaluation of its therapeutic potential and better understanding the tasks for professionals. Methods: Our Сenter performed 705 kidney transplants (RTx) between April 1986 and October 2016. The median recipient age was 42.6 years with M:F ratio of 1.6:1. Most of them were on hemodialysis (96%), 28 patients received pre-emptive transplant, 517 (73.3%) transplants were from deceased donors, 184 (26.7%) were from living donors. Results: Patients in the start and more late stage of transplant program had the following significant differences: the range of their age has been changed from 14-62 to 6-71 years. Transplantations from deceased donors decreased from 98.7% to 40.3% of cases. Last decades, more and more patients who were not considered as transplant candidates earlier have been referred to kidney transplantation. Amount of high risk factors such as diabetes, systemic lupus erythematosus, amyloidosis and other increased dramatically. Miniinvasive and other modern surgery technology were introduced. Immunosuppression at the beginning consisted of cyclosporine, azathioprine and steroids. Later in all cases of induction anti-CD-25 monoclonal or other depleting antibodies were used. Immunosuppression maintenance spectrum was added by tacrolimus, prolonged-release tacrolimus, mycophenolate mofetil, mycophenolate sodium or everolimus. Over the last decade steroid-free protocols were used in about 30% of all primary RTx to avoid the long-term side effects of steroid use. Immunosupression-free protocol in one recipient with normal graft function is using last 3 years. Our data showed that in spite of extension of indications, the number of primary functioning kidney transplant increased from 71.2 % to 78.3 %. It makes the best start for long-term rehabilitation of recipients. One-year survival of high
Aim: To summarize our single – center experience in renal transplantation (RT), analyze the trends and review the influence of these trends on outcomes of RTx for further evaluation of its therapeutic potential and better understanding the tasks for professionals. Methods: Our Сenter performed 705 kidney transplants (RTx) between April 1986 and October 2016. The median recipient age was 42.6 years with M:F ratio of 1.6:1. Most of them were on hemodialysis (96%), 28 patients received pre-emptive transplant, 517 (73.3%) transplants were from deceased donors, 184 (26.7%) were from living donors. Results: Patients in the start and more late stage of transplant program had the following significant differences: the range of their age has been changed from 14-62 to 6-71 years. Transplantations from deceased donors decreased from 98.7% to 40.3% of cases. Last decades, more and more patients who were not considered as transplant candidates earlier have been referred to kidney transplantation. Amount of high risk factors such as diabetes, systemic lupus erythematosus, amyloidosis and other increased dramatically. Miniinvasive and other modern surgery technology were introduced. Immunosuppression at the beginning consisted of cyclosporine, azathioprine and steroids. Later in all cases of induction anti-CD-25 monoclonal or other depleting antibodies were used. Immunosuppression maintenance spectrum was added by tacrolimus, prolonged-release tacrolimus, mycophenolate mofetil, mycophenolate sodium or everolimus. Over the last decade steroid-free protocols were used in about 30% of all primary RTx to avoid the long-term side effects of steroid use. Immunosupression-free protocol in one recipient with normal graft function is using last 3 years. Our data showed that in spite of extension of indications, the number of primary functioning kidney transplant increased from 71.2 % to 78.3 %. It makes the best start for long-term rehabilitation of recipients. One-year survival of high