THE MEDICAL AND SURGICAL COMPLICATIONS
OF LIVING DONOR ALLOTRANSPLANTATION IN
RECIPIENTS AND THEIR IMPACT ON PATIENTS
AND GRAFT SURVIVAL
By
El-Metwally El-Shahawy, M.D.; A. Hifny, M.O., MRCP;
M. Ghoneim*. M.D.; M. Shawki, M.D.; N. Khattab, M.D.;
Yehia Saddik, M.D.; M. Salem, M.O. and A. Ibrahim
Department of Internal Medicine, Benha Faculty of Medicine and Mansoura Urology and Nephrology Centre*
ABSTRACT
The aim of the present work is to study the incidence, management and outcome of medical and surgical complications following living donor allotransplantation in recipients and their impact on patient and graft survival. The material of the present work comprised 200 patients suffering from end stage renal disease of variable aetiology. These patients were subjected to thorough clinical, laboratory and radiological evaluation. They were treated initially by dialysis therapy (with the exception of six patients) for variable periods of time before being transplnted. Histocompatibility tests were done for both donors and recipients to choose the donor with the best tissue similarity and these include HLA. DR, MLC and Direct Cross Matching. Minimum clinical fcllow-up following transplantation was 1 year. The results of this work showed:
* Early postoperative complications comprised acute tubular necrosis in
18 cases (9%) but all of them recovered; acute rejection which was
irreversible in 8 cases (4%); infections that were also properly treated;
hypertension and diabetes mellitus were easily controlled.
* Late medical complications comprised many items, of which rejection,
liver dysfunction, septicaemia and malignancy were most serious.
However, infections, hypertension and diabetes mellitus may also accur
lately.
* No deaths occurred as a result of surgical complications which can be
explained by early diagnosis and management.
* One year graft survival was in 85% of the transplanted patients, and one
year patient survival was in 93% of these patients also. These results are
approaching the international published ones.
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