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Saudi Journal of Kidney Diseases and Transplantation
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LETTER TO THE EDITOR Table of Contents   
Year : 1996  |  Volume : 7  |  Issue : 1  |  Page : 38-39
Kidney Transplantation from Living Unrelated Donors


Faculty of Medicine, Aleppo University Hospital Aleppo, Syria

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How to cite this article:
Al Asfari R, Hadidy S, Yagan S. Kidney Transplantation from Living Unrelated Donors. Saudi J Kidney Dis Transpl 1996;7:38-9

How to cite this URL:
Al Asfari R, Hadidy S, Yagan S. Kidney Transplantation from Living Unrelated Donors. Saudi J Kidney Dis Transpl [serial online] 1996 [cited 2014 Aug 2];7:38-9. Available from: http://www.sjkdt.org/text.asp?1996/7/1/38/39540
To the Editor:

We herewith describe the follow-up data of 38 patients (22 male and 16 female) who underwent renal transplantation in India from living unrelated donors between March 1988 and December 1993. The age of the patients ranged between 15 to 64 years. The mean period of stay in India was four weeks and the mean period of hospitalization post-transplantation was 15 days.

The duration of follow-up ranged between 2 to 60 months. During this period, major medical complications encountered included hypertension in 22 patients (57.9%), cushingoid features in 20 (52.6%), acne in 18 (47.4%), urinary tract infection in 17 (44.7%) and obesity in 13 (34.2%). The surgical complications encountered included delayed wound healing in three patients (7.9%) and hydrocele in two (5.3%). A total of five acute rejection episodes were encountered of which four responded to methyl prednisolone therapy. Six patients had chronic rejection of whom two lost their graft function one and two years post­transplantation respectively and were back on hemodialysis. A third graft was lost due to irreversible acute rejection at three months after transplantation.

A total of 11 patients (28.9%), six females and five males, died during the follow-up period. Four of them died within the first six months of transplantation, one died after 10 months while the remaining six died between 16 to 27 months following transplantation. The cause of death in these patients included bacteremia in four (36.4%), pneumonia and cardiovascular complications in two patients each (18.2%), viremia and hepatic failure in one patient each (9.1%). One patient (9.1%) died after one year following return to hemodialysis. The serum creatinine level of the 27 surviving patients ranged between 71 and 177 µmol/L at the end of the study period.

These results are inferior to that seen by us in patients who underwent living related donor transplants in Syria or Turkey [1] . Similar unfavorable outcome has been reported by other workers as well [2] . The reasons for this poor outcome could be related to poor patient and donor evaluation and selection.

The ethical moral and religious aspects of commercial renal transplantation have been discussed by several authors and this form of treatment has been considered unaccept­able on all grounds [2],[3],[4],[5],[6],[7] . One way of curtailing commercial renal transplantation is by enforcing strict laws against this practice in the countries where this is practiced. Also, renal care physicians and the media should actively campaign encouraging living related donation. Also, all efforts should be made to organize active cadaveric transplant programs in countries wherein such programs do not already exist.

 
   References Top

1.Al Asfari R, Hadidy S, Munla F. Follow-up of fifty cases of renal transplantation performed at different centers in recent advances in nephrology and transplantation. 1990). ed Haberal MA. Ankara.  Back to cited text no. 1    
2.Abouna GM, Kumar MS, White AG. Moral ethical and medical values sacrified by comerciali-zation in human organs in organ transplantation 1990 (eds).  Back to cited text no. 2    
3.Abouna GM, Kumar MS, Samhan M, Dadah SK, John P, Sabawi NM. Commercialization in human organs: a middle eastern perspective. Transplant Proc 1990;22(33):918-21.  Back to cited text no. 3    
4.Dossetor JB, Abouna GM, Kumar MS, White AG. (1990). Ethics and transplantation. An analysis of rewarded grafting in organ transplantations (eds) Kulwer academic publisher.  Back to cited text no. 4    
5.Reddy K.C, Thiagarajan CM, Shunmugasundaram D, et al. Unconventional renal transplantation in India. Transplant Proc 1990;22(3):910-­11.  Back to cited text no. 5    
6.Colabawall BN, Abouna GM, Kumar MS, White AG. Commerce and trade in human organs transplantation. Kuwer academic publisher.  Back to cited text no. 6    
7.Rispler Chaim V. Islamic medical ethics in the 20th century. J Med Ethics 1989;15:203-8.  Back to cited text no. 7    

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Correspondence Address:
Riad Al Asfari
Faculty of Medicine, Aleppo University Hospital Aleppo
Syria
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PMID: 18417917

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