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Saudi Journal of Kidney Diseases and Transplantation
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Year : 2018  |  Volume : 29  |  Issue : 6  |  Page : 1523-1536
Organ transplantation in Saudi Arabia – 2017



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Date of Web Publication27-Dec-2018
 

How to cite this article:
. Organ transplantation in Saudi Arabia – 2017. Saudi J Kidney Dis Transpl 2018;29:1523-36

How to cite this URL:
. Organ transplantation in Saudi Arabia – 2017. Saudi J Kidney Dis Transpl [serial online] 2018 [cited 2019 Jan 18];29:1523-36. Available from: http://www.sjkdt.org/text.asp?2018/29/6/1523/248284
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 2017 a total of 11,509 kidneys were transplanted; 7,838 were from living related donors, 3,108 from deceased donors and 563 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 921 kidneys were transplanted this year; 776 were from living donors and 145 from deceased donors. Among the 145 deceased kidneys, 26 were used for pediatric recipients and 119 for adults.

Liver transplantation program in the Kingdom was started in 1990 and by the end of 2017 a total of 2,233 livers were transplanted. This included 1,133 livers from living related donors, 95 from living unrelated donors and 1,005 form deceased donors.

Liver transplant operations are performed in four active centers; King Faisal Specialist Hospital and Research Center-Riyadh, King Fahd Specialist Hospital-Dammam, King Abdulaziz Medical City/National Guard Hospital-Riyadh and Prince Sultan Military Medical City-Riyadh. In this year, 147 livers were transplanted from living donors and 79 from deceased donors.

The first heart transplant operation in the Kingdom was performed in 1986 at Riyadh Military Hospital. During the period (1986–2017), a total of 376 whole heart transplantations were done inside the Kingdom, in addition to 650 hearts used as source of valves. In this year, 37 whole hearts were transplanted and 21 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 2017, a total of 285 lungs were transplanted to 160 recipients as single or double. In this year, 72 lungs were transplanted to 37 recipients.

Pancreas transplantation was started at Al-Shaty Teaching Hospital-Jeddah. A total of 64 pancreas were transplanted since the inception of the program in 1990. In this year 18 pancreas transplantations were done, 16 at King Faisal Specialist Hospital and Research Center-Riyadh and two at King Fahd Specialist Hospital-Dammam.

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 these programs, a total of 700 corneas, 410 bones and 144 multiskeletal tissues were recovered. In this year, 79 bones and 27 multiskeletal tissues were procured in addition to two corneas retrieved by King Khalid Eye Specialist Hospital-Riyadh.

Results from the organ sharing program between the Kingdom and GCC countries showed that a total of 67 kidneys, 156 livers, 24 whole hearts, 60 hearts for valves, 56 lungs, and three pancreas were shared and transplanted inside the Kingdom since the start of this program in 1996. In this year 37 organs were transplanted inside the Kingdom from this program including; two kidneys, 14 livers, three whole hearts, 16 lungs and two pancreases in addition to two hearts for valves.


   Kidney Transplantation - 2017 Top


A total of 921 kidneys were being transplanted inside the Kingdom during this year, 776 were from living donors and 145 from deceased donors.

Regarding kidneys from deceased donors, a total of 123 cases were consented for kidney donation from which 177 kidneys were transplanted. One hundred forty-five were transplanted inside the Kingdom, 26 in Kuwait and 6 in United Arab Emirates. The following table shows the performance of kidney transplant centers during the year 2017.



Out of the 145 deceased kidneys, 121 (83%) were transplanted from standard criteria donors (SCD) and the remaining 24 (17%) were from expanded criteria donors (ECD).

Kidney Donor Risk Index (KDRI) for locally deceased donors was ranging between 0.73 and 2.58 with an average of 1.23. It is worth mentioning that 23 (31%) of the cases has a KDRI less than one, 38 (51%) were between (1.0 and 1.5), and 14 (18%) had a KDRI above 1.5.

The cold ischemia time (CIT) for locally transplanted deceased kidneys was ranging between 2 hours 30 minutes to 29 hours 26 minutes with an average CIT of 10 hours. In 75% of the cases; the deceased kidney transplantation was done with a CIT of less than 12 hours, in 22% transplantation was done within (12–24 hours) and in only 3% it was done within (24–29 hours).

Matching sex (male to male or female to female) was done in 55% of kidneys transplanted and matching blood groups in 95% of the cases. Age distribution for donors and recipients of deceased kidneys is shown in the table below:



Kidneys were not recovered from eligible donors after consent in 27 cases (54 kidneys) for reasons indicated in the table below.



One hundred ninety four kidneys were discarded after recovery due to the following causes:



Living Kidney Transplantation – 2017

A total of 776 kidney transplantations had been performed this year from living donors; 671 (86%) were from living related donors and 105 (14%) from living unrelated donors. The total number of kidneys transplanted from living donors since 1988 was 8,401 including 7838 kidneys from living related donors and 563 from living un-related donors.


   Liver Transplantation – 2017 Top


One hundred twenty two deceased cases were consented for liver donation this year. Seventy four cases were utilized from which 79 livers were transplanted (including 5 split livers). Livers were not retrieved from 35 cases while in 13 cases livers were discarded after harvesting.

Deceased liver transplant operations were distributed between King Abdulaziz Medical City/National Guard-Riyadh (29 operations), King Faisal Specialist Hospital-Riyadh (27 operations including 5 split livers), and King Fahd Specialist Hospital-Dammam (23 operations). 87% of the deceased livers were transplanted for adult recipients and 13% went for pediatric recipient.

CIT for locally transplanted deceased livers was ranging from one hour 52 minutes to 25 hours 36 minutes with an average of 7 hours 48 minutes. In 39% of the cases, livers were transplanted with CIT of <6 hours in 58% of the cases within (6–12 )hours, and only two livers (3%) were transplanted with CIT greater than 12 hours.

Matching sex between donor and recipient for deceased livers was done in 57% of the cases and matching blood group in 85% of the cases.

Livers were not recovered in 35 cases due to the reasons in the table below.



Livers were discarded by transplant centers after retrieval in 13 cases due to the following reasons:



Liver from Living Donors – 2017

A total of 147 liver transplantations were performed this year from living doors; 131 (89%) were from living related donors and 16 (11%) were from living un-related donors. Liver Transplantation from living donors was performed in five active centers indicated in the table below.




   Heart Transplantation – 2017 Top


A total of 117 consents were obtained for heart donation this year (94% of total consents), 37 whole hearts were recovered and transplanted inside the Kingdom, 35 at King Faisal Specialist Hospital and Research Center-Riyadh (26 for adults and 9 for pediatrics) and two at Prince Sultan Military Medical City for adult recipient. In addition; 21 hearts were also harvested to be used as a source for valves; all were given to King Faisal Specialist Hospital and Research Center-Riyadh.

Matching sex between donor and recipient for heart transplantation was done in 30 (81%) of the cases while matching blood group was done in 28 (76%) of the cases.

Fifty eight cases were consented for donation but not recovered due to the reasons indicated below.



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




   Lung Transplantation – 2017 Top


A total of 117 consents were obtained this year for lung donation (94% of total consents) from which 37 donors were utilized to transplant 72 lungs; 70 as double for 35 recipients and two as single to another two recipient. All lung transplant operations were done at King Faisal Specialist Hospital-Riyadh. Lungs were not recovered from 76 deceased donors while in other four cases lungs were discarded after retrieval.

Matching sex was done in 22 (59%) of the lungs transplanted while matching blood group was done in 32 (86%) of the cases.



Lungs were not recovered from 76 donors (152 lungs) after consent for the reasons in the table below.



Lungs from five donors (10 lungs) were discarded after recovery due to the following reasons:





Total lungs transplanted: 285

Total lung transplant recipient: 160


   Pancreas Transplantation – 2017 Top


One hundred eighteen (118) eligible deceased donors were obtained this year for pancreas donation; 97 were from inside the kingdom and 21 from GCC countries. Eighteen pancreas were recovered and transplanted; 11 in a simultaneous kidney-pancreas operations (SKP) and 7 in a pancreas alone transplantation (PTA) operation. Pancreas transplant operations were performed at King Faisal Specialist Hospital and Research Center-Riyadh (16 operations) and King Fahd Specialist Hospital-Dammam (2 operations).

Three pancreas were recovered inside the Kingdom but not transplanted and (78) were consented for donation but not recovered due to the following reasons:



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 – 2017 Top


Corneal tissue donation and transplantation program in the kingdom was started in 1983 in which corneas were being recovered alongside with the multi-organ retrieval process from deceased donors. In this year consent for corneal donation was obtained from 46 (37%) cases, 29 from inside the Kingdom and 17 from GCC countries. Only two corneas were retrieved inside the Kingdom by King Khalid Eye Specialist Hospital-Riyadh from one donor while corneas were not retrieved from the remaining 28 donors.

Reasons for not recovering the 56 corneas consented inside the Kingdom are indicated in following table:



It is worth mentioning that King Khalid Eye Specialist Hospital-Riyadh, being the most active corneal transplant center in the Kingdom, in 2017 it succeeded to procure 1,366 corneas from abroad, of which, 667 corneas were transplanted and 699 corneas were sent to other eye care facilities


   Bone Transplantation – 2017 Top


Bone donation from deceased donors in the Kingdom was started at King Faisal Specialist Hospital and Research Center-Riyadh in 2009. At present, bone recovery, in the central region, is done alongside with the multi-organ recovery process from deceased donors.

In this year 27 (22%) cases were consented for bone and musculoskeletal tissue (MST) donation. Twenty donors were harvested from which 79 bones and 27 MST were recovered. It is worth mentioning that since the inception of this program in the Kingdom, a total of 410 bones had been recovered in addition to 144 musculoskeletal connective tissues for the purpose of bone allograft. Performance of deceased bone and MST recovery in 2017 is shown below.



Organ Transplantation in the Kingdom of Saudi Arabia







Organ Transplantation in the Kingdom of Saudi Arabia







Organ Transplantation in the Kingdom of Saudi Arabia







Organ Transplantation in the Kingdom of Saudi Arabia







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