Investigation of graft and patient survival in high-urgent kidney transplantation from cadavers

Investigation of Graft and Patient Survival in High-Urgent Kidney Transplantation from Cadevers Patient with end-stage real disease (ESRD) can survive if treated by hemodialysis, peritoneal dialysis or transplantation. However, some patients with lack of access for either hemodialysis or peritoneal dialysis require urgent kidney transplantation to survive. The literature data on this patient group is quite limited. In our study, it is aimed to examine the graft and patient survival in high-urgent kidney transplants (HU-KT) from cadavers in our center. The data of 26 patients who underwent high-urgent kidney transplantation from cadevers in our center between January 2008 and December 2020 were evaluated retrospectively. A p value less than 0.05 was considered statistically significant. The recipients' mean age was 44 years. 11 (42,3%) of the recipients were male and 15 (57.7%) were female. Graft loss was observed in 11 (42.3%) patients during follow-up. Graft loss occurred due to death in 6 patients, chronic rejection in 2 patients, sepsis in 1 patient, renal rupture in 1 patient, and renal vein thrombosis in 1 patient. 11 patients (42.3%) died during follow-up. 6 (54.5%) patients died due to unknown reasons, 4 (36.4%) patients died due to sepsis+MODS and 1 (9.1%) patient died due to sudden cardiopulmonary arrest. The mean death uncensored graft survival time is 100.4 months. Death uncensored graft survival rates were calculated as 84.6%, 84.6%, 69.2% and 57.7% at 1, 2, 5 and 10 years, respectively, The mean age of patients with uncensored graft loss was observed to be higher. The mean death uncensored graft survival time is 122.1 months. Death censored graft survival rates were calculated as 92.1%, 92.1%, 83.8% and 78.8% at 1, 2, 5 and 10 years, respectively. The rate of development of chronic graft rejection was found to be higher in patients with death censored graft loss. The mean survival time of the patients is 106.5 months. Patient survival rates were calculated as 92.3%, 92.3%, 73.1% and 55.9% for 1, 2, 5 and 10-year, respectively. In the Kaplan-Meier analysis, the survival rate of patients aged 45 years and older was found to be lower than those under 45 years of age. Increase in recipient age and development of acute rejection after transplantation were determined as independent risk factors for survival. No statistically significant difference was observed in the survival comparison made with the cadaver waiting list of our center. Considering that the patients in the high-urgent transplant group have intense vascular problems and that they will die in a short time if the transplant is not performed, this result can be considered positive. The literature data on high-urgent kidney transplantation is limited. High-urgent kidnet transplantation is the only life-saving treatment option in patients with lack of vascular or peritonal access for dialysis. Key Words: High-urgent kidney transplantation, Deceased Donor, Patient and Graft Survival