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Saudi Journal of Kidney Diseases and Transplantation
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Year : 2017  |  Volume : 28  |  Issue : 6  |  Page : 1456-1469
Organ transplantation in Saudi Arabia – 2016



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Date of Web Publication18-Dec-2017
 

How to cite this article:
. Organ transplantation in Saudi Arabia – 2016. Saudi J Kidney Dis Transpl 2017;28:1456-69

How to cite this URL:
. Organ transplantation in Saudi Arabia – 2016. Saudi J Kidney Dis Transpl [serial online] 2017 [cited 2019 Dec 9];28:1456-69. Available from: http://www.sjkdt.org/text.asp?2017/28/6/1456/220850


Organ transplantation program in the Kingdom started in 1979 when the first kidney from a living donor was transplanted in Riyadh Military Hospital, and by the end of 2016 a total of 10,588 kidneys were transplanted; 7167 were from living related donors, 2963 from deceased donors and 458 from living unrelated donors. The program received a big boost with the inception of the National Kidney Foundation in 1984 and further in 1993 when the organization was upgraded and renamed as Saudi Center for Organ Transplantation (SCOT).

Kidney transplantation program showed that total of 798 kidneys were transplanted this year; 673 were from living donors and 125 from deceased donors. Among the 125 deceased kidneys, 21 were used for pediatric recipients and 104 for adults.

Liver transplantation program in the Kingdom was started in 1990 and by the end of 2016 a total of 2007 livers were transplanted. This included 1002 livers from living related donors, 79 from living unrelated donors and 926 form deceased donors.

Liver transplant operations are performed in four active centers; King Faisal Specialist Hospital & Research Center-Riyadh, King Fahd Specialist Hospital-Dammam, King Abdulaziz Medical City and National Guard-Riyadh, and Prince Sultan Military Medical City-Riyadh. In this year 145 livers were transplanted from living donors and 69 from deceased donors.

The first heart transplant operation in the Kingdom was performed in 1986 at Riyadh Military Hospital. During the period (1986–2016), a total of 339 whole heart transplantations were done inside the Kingdom, in addition to 629 hearts used as source of valves. In this year, 29 whole hearts were transplanted and 10 hearts were recovered to be used as source for valves.

Lung transplantation in the Kingdom was started in 1991 at King Fahd Hospital-Jeddah. And by the end of 2016, a total of 213 lungs were transplanted to 123 recipients as single or double. In this year 31 lungs were transplanted to 16 recipients.

Pancreas transplantation was started at Al-Shaty Teaching Hospital-Jeddah. A total of 46 pancreas were transplanted since the inception of the program in 1990. In this year 11 pancreas transplantations were done at King Faisal Specialist Hospital-Riyadh.

Tissue donation program (cornea, bones and other multiskeletal connective tissue), was started in 1983 for cornea and in 2009 for bones and multiskeletal tissue. Since the start of this program, a total of 698 corneas, 331 bones and 117 multiskeletal tissues were recovered. In this year 61 bones and 12 multiskeletal tissues were procured while no corneas were harvested locally from deceased donors.

Results from the organ sharing program between the Kingdom and GCC countries showed that a total of 68 kidneys, 142 livers, 21 whole hearts, 58 hearts for valves, 40 lungs, and one pancreas were shared and transplanted inside the Kingdom since the start of this program in 1996. In this year 28 organs and tissues were recovered and transplanted inside the kingdom.

Kidney Transplantation – 2016

A total of 798 kidneys were being transplanted inside the Kingdom during this year, 673 were from living donors and 125 from deceased donors.

Regarding kidneys from deceased donors, a total of 102 cases were consented for kidney donation from which 157 kidneys were transplanted. 125 were transplanted inside the Kingdom to 123 recipients (including 4 kidneys as en-bloc), 30 were transplanted in Kuwait and 2 in United Arab Emirates. The following table shows the performance of kidney transplant centers during the year 2016.

Living and Deceased Kidney Transplantation in the Kingdom – 2016



Out of the 125 deceased kidneys, 88 (70%) were transplanted from standard criteria donors (SCD) and the remaining 37 (30%) were from expanded criteria donors (ECD).

Kidney Donor Risk Index (KDRI) for locally recovered deceased kidneys was ranging between 0.72 and 2.16 with an average of 1.24. It is worth mentioning that 6% of the cases has a KDRI <0.8, 41% were between (0.8 -1.15), 25% between (1.15 – 1.45) and 28% had a KDRI above 1.45.

The cold ischemia time (CIT) for locally transplanted deceased kidneys was ranging from 2 hours and 41 minutes to 34 hours and 48 minutes with an average CIT of 12 hours. In 57 % of the cases; the deceased kidneys transplantation was done with a CIT of less than 12 hours, in 36% within (12–24 hours), and in only 7% within (24–29 hours).

Matching sex (male to male or female to female) was done in 56% of the kidneys transplanted and matching blood groups in 96% of the cases. Age distribution for donors and recipients of deceased kidneys is shown in the table below.

Age distribution of recipients and donors of the deceased kidneys – 2016



Kidneys were not recovered from eligible donors after consent in 30 cases for the reasons indicated in the table below.

Reasons for not recovering kidneys from eligible deceased donors – 2016



Eleven kidneys were discarded after recovery due to the following causes:



Living Kidney Transplantation-2016

A total of 673 kidney transplantations had been performed this year from living donors; 584 (87%) were from living related donors and 89 (13%) from living unrelated donors. The total number of kidneys transplanted from living donors since 1988 is 7625 including 7167 kidneys from living related donors and 458 from living un-related donors.

Liver Transplantation – 2016

One hundred and two deceased cases were consented for liver donation this year. 63 cases were utilized from which 69 livers were transplanted (including 6 split livers). Livers were not retrieved from 30 cases while in 9 cases livers were discarded after harvesting.

Deceased liver transplant operations were distributed between King Faisal Specialist Hospital-Riyadh (24 operations), King Abdulaziz Medical City and National Guard-Riyadh (27 operations), and King Fahd Specialist Hospital-Dammam (18 operations). 86% of the deceased livers were transplanted for adult recipients and 14% went for pediatric recipient.

CIT for locally transplanted deceased livers was ranging from 1 hour 30 minutes to 11 hours 47 minutes with an average of 6 hours 12 minutes. In 49% of the cases, livers were transplanted with CIT ≤6 hours and in 51% of the cases within 6-12 hours.

Matching sex between donor and recipient for deceased livers was done in 54% of the cases and matching blood group in 78% of the cases.

Livers were not recovered in 30 cases due to the reasons in the table below.

Reasons for not recovering livers from eligible deceased donors – 2016



Livers were discarded by transplant centers after retrieval in 9 cases due to the following reasons:

- Neoplasm (3 cases)

- Inflammation /fibrosis (2 cases)

- Steatosis (2 cases)

- Liver Laceration (1 case)

- Long CIT (1 case)

Liver from Living Donors – 2016

A total of 145 liver transplantations were performed this year from living doors; 136 (94%) were from living related donors and 9 (6%) were from living un-related donors. Liver Transplant from living donors was done in four active centers indicated in the table below.

Performance of living liver transplant centers – 2016



Heart Transplantation – 2016

A total of 99 consents were obtained for heart donation this year (97% of total consents), 29 whole hearts were recovered and transplanted, 28 at King Faisal Specialist Hospital-Riyadh (25 for adults and 3 for pediatric) and one at Prince Sultan Military Medical City for adult recipient. In addition; 10 hearts were also harvested to be used as a source for valves; all were given to King Faisal Specialist Hospital-Riyadh.

Matching sex between donor and recipient for heart transplantation was done in 66% of the cases while matching blood group was done in 89%.

Sixty hearts were consented for donation but not recovered due to the reasons in the table below.

Reasons for not recovering hearts from eligible deceased donors – 2016



Heart for valves recovery and utilization is shown in the table below:

Heart for valves recovery and utilization – 2016



Lung Transplantation - 2016

A total of 99 consents were obtained this year for lung donation (97% of total consents) from which 16 donors were utilized and 31 lungs were transplanted; 30 as double for 15 recipients and one as single to another recipient; all were performed at King Faisal Specialist Hospital-Riyadh. Lungs were not recovered in 80 cases and discarded only in 3 cases.

Matching sex was done in 69% of the lungs transplanted while matching blood group was done in 75% of the cases.

Transplanted from deceased donors – 2016



Lungs were not recovered from 80 donors (160 lungs) after consent for the reasons in the table below.

Reasons for not recovering lungs from eligible deceased donors – 2016



Lungs from 3 donors (6 lungs) were discarded after recovery due to the following reasons: congested lungs (2 cases), non-oxygenated lungs (2 cases), and infection (2 cases).

Deceased lung transplantation activity in the Kingdom



Total lungs transplanted: 213

Total lung transplant recipient: 123

Pancreas Transplantation – 2016

Ninety nine (99) eligible deceased donors were obtained this year for pancreas donation; 81 were from inside the kingdom and 18 from GCC countries. Eleven pancreas were recovered and transplanted; 4 in a simultaneous kidney-pancreas operations (SKP), six in a pancreas alone transplantation (PTA) operation and one in a multi-visceral transplant operation (pancreas, liver, and small intestine). Pancreas transplant operations were performed at King Faisal Specialist Hospital-Riyadh (10 operations) and King Fahd Specialist Hospital-Dammam (1 operation).

Sixty eighty (68) pancreases were consented inside the Kingdom but not recovered for the reasons indicated in the table below:

Reasons for not recovering pancreas from eligible deceased donors-2016



It is worth mentioning that the first pancreas transplant operation was done in 1990, followed by two combined kidney-pancreas operations in 1991. Another combined kidney-pancreas operation was also done in 1992 at Al-Shaty Hospital in collaboration with King Abdul-Aziz Hospital–Jeddah.

Cornea Transplantation – 2016

Corneal tissue donation and transplantation program in the kingdom was established in 1983 in which corneas were recovered along with the multi-organ retrieval from deceased donors. In this year consent for corneal donation was obtained from 42 (41%) cases, 24 from inside the Kingdom and 18 from outside the Kingdom (GCC). No corneas were retrieved inside the Kingdom this year. Reasons for not recovering the 48 corneas consented inside the Kingdom are indicated in following table:

Reasons for not recovering corneas from eligible deceased donors - 2016



It is worth mentioning that King Khalid Eye Specialist Hospital-Riyadh, being the most active corneal transplant center in the Kingdom. It performed 810 corneal transplantations harvested from abroad, in addition to 615 corneas sent to other eye care facilities in the Kingdom.

Bone Transplantation - 2016

Bone donation from deceased donors in the Kingdom was started at King Faisal Specialist Hospital-Riyadh in 2009. At present, bone recovery, in central region, is done along with the multiorgan recovery from deceased donors.

In this year 13 (13%) cases were consented for bone and musculoskeletal tissue (MST) donation. Eleven donors were harvested from which 61 bones and 12 MST were recovered. It is worth mentioning that a total of 331 bones had been recovered in addition to 117 musculoskeletal connective tissues for the purpose of bone allograft since the inception of bone donation program in the Kingdom.

Performance of deceased bone and MST recovery in 2016 is shown below.




   Organ Transplantation in the Kingdom of Saudi Arabia Top









   Organ Transplantation in the Kingdom of Saudi Arabia Top









   Organ Transplantation in the Kingdom of Saudi Arabia Top









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DOI: 10.4103/1319-2442.220850

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