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Saudi Journal of Kidney Diseases and Transplantation
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RENAL DATA FROM THE ARAB WORLD Table of Contents   
Year : 2000  |  Volume : 11  |  Issue : 1  |  Page : 82-83
Early Experience of Kidney Transplantation in Yemen: The First Two Cases


1 Head of Nephrology Department, Saudi Hospital at Hajjah, Yemen
2 Head of Urology Department, Al-Thawrah Hospital, Sanaa, Yemen

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How to cite this article:
Al-Rohani M, Al-Nunu I. Early Experience of Kidney Transplantation in Yemen: The First Two Cases. Saudi J Kidney Dis Transpl 2000;11:82-3

How to cite this URL:
Al-Rohani M, Al-Nunu I. Early Experience of Kidney Transplantation in Yemen: The First Two Cases. Saudi J Kidney Dis Transpl [serial online] 2000 [cited 2014 Dec 22];11:82-3. Available from: http://www.sjkdt.org/text.asp?2000/11/1/82/36699

   Introduction Top


Kidney transplantation in Yemen was started in May 1998. To initiate the program we encountered many problems. We had to overcome two major problems in order to avoid cyclosporine (CsA) nephrotoxicity and acute rejection: a) The need for renal biopsy. b) Cyclosporine level monitoring (which were not available at that time).

Two adult patients received kidneys from genetically related living donors. We briefly present the preoperative and postoperative results of the first six months follow-up.

First Case

A 27-year-old man with end- stage renal failure (ESRF) who had been on hemodialysis twice weekly for the previous six months was accepted for renal transplantation. HIV, anti-HCV and HBsAg were negative. Before transplantation, the dry weight was 77.3 kg and blood pressure (BP) was controlled by antihypertensive medications. His healthy brother who had full matching of HLA antigens and negative antibodies cross matching with the patient, volunteered to be a living donor to the patient. The operation was done on 23 rd of May 1998 without any intra operative complications. The kidney started functioning directly after surgery. The serum creatinine and urea became normal after 36 hours. Duration of hospitalization was 28 days. During the follow-up period the patient's general condition improved. However, he still required antihypertensive medications to control his blood pressure. Nevertheless, the gradual reduction of the prednisolone dose lead to the reduction of blood pressure. His weight increased up to 81 kg. Follow-up blood investigations showed normal serum creatinine, electro­lytes, glucose and hemoglobin.

Second Case

A 29-year-old man with ESRF who was HCV seropositive but negative for HIV and HbsAg, was accepted for live-donor trans­plantation. He had been on three hours of hemo-dialysis twice weekly over the previous three years. Before transplantation the dry weight was 54 kg. His healthy 22­year-old cousin who had two out of six matching of HLA antigens and negative antibodies cross matching with the patient, volunteered to donate a kidney to the patient. The operation was done on October 1st 1998 without any intraoperative compli­cations. The kidney started functioning directly after surgery. The serum creatinine and urea became normal after 24 hours of surgery. Duration of hospitalization was 28 days. The serum glucose increased up to 450 mg/dl after the operation, but with reduction of steroids, it became normal within 13 days. During six months the general condition of the patient improved.


   Comment Top


CsA blood levels and renal biopsy are methods of evaluation for CsA nephro­toxicity. Both methods were not available for us. To avoid the medical and technical problems with CsA mentioned above, MMF-based immunosuppression was used with steroids.[1],[2],[3]

 
   References Top

1.Zanker B, Schneeberger H, Rothenpieler U, et al. Mycophenolate Mofetil-based, cyclos-porine-free induction and maintenance immunosuppression: first-3­months analysis of efficacy and safety in two cohorts of renal allograft recipients. Transplantation 1998;66:44-9.  Back to cited text no. 1  [PUBMED]  [FULLTEXT]
2.Stegall MD, Simon M, Wachs ME, Chan L, Nolan C, Kam I. Mycophenolate mofetil decreases rejection in simultaneous pancreas-kidney transplantation when combined with tacrolimus or cyclosporine. Transplantation 1997;64:1695-700.  Back to cited text no. 2  [PUBMED]  [FULLTEXT]
3.Schrama YC, et al. Cyclosporine-sparing protocols with CellCept. 17 th Annual Meeting of the American Society of Transplant Physicians (ASTP), Chicago, USA, May 1998.  Back to cited text no. 3    

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Correspondence Address:
Muhamed Al-Rohani
Department of Nephrology, Saudi Hospital at Hajjah, P.O. Box 4365, Hudaidah
Yemen
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PMID: 18209305

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Editors note: We publish this straightforward experience to encourage the institutions that have not yet started this essential branch of renal replacement therapy.




 

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