Abstract: PO2419
Clinical Outcomes of Kidney Transplant Recipients Living Away from Their Home Country
Session Information
- Clinical and Immunologic Predictors of Post-Transplant Outcomes
October 22, 2020 | Location: On-Demand
Abstract Time: 10:00 AM - 12:00 PM
Category: Transplantation
- 1902 Transplantation: Clinical
Authors
- Rahiman, Ramzi Abdul, Hamad Medical Corporation, DOHA, Qatar
- Osman, Maab Abdelrahman mahgoub, Hamad Medical Corporation, DOHA, Qatar
- Alfar, Hadeel, Hamad Medical Corporation, DOHA, Qatar
- Abuhelaiqa, Essa, Hamad Medical Corporation, DOHA, Qatar
- Asim, Muhammad, Hamad Medical Corporation, DOHA, Qatar
- Fituri, Omar, Hamad Medical Corporation, DOHA, Qatar
- Hamdi, Ahmed Farouk, Hamad Medical Corporation, DOHA, Qatar
- Al-Malki, Hassan A., Hamad Medical Corporation, DOHA, Qatar
- Alkadi, Mohamad M., Hamad Medical Corporation, DOHA, Qatar
Background
Many people leave their home country looking for better job opportunities and among those are kidney transplant recipients. However, taking care of such recipients might be challenging especially when information regarding induction immunosuppression, donor HLA typing, donor-specific antibodies, crossmatch and/or infections are not available.The aim of this study was to compare clinical outcomes of kidney recipients transplanted in their home conutry with kidney recepients transplanted locally.
Methods
In this retrospective cohort, we included all adult recipients transplanted between 2005 and 2016 and followed at our transplant clinics within their first year of transplant. Patients were categorized into two groups; local group including recipients transplanted at our center and abroad group including recipients transplanted in their home country.
Results
There were 111 patients in local group and 110 patients in abroad group. The mean age at transplant in local and abroad groups were 48 and 42 year-old, respectively. 63% of receipients in local group were from the Middle East, while 53% of patients transplanted abroad were from South Asia. Deceased donation was higher in local group (41% vs. 4%; p<0.0001). There was no difference in recipient sex, native kidney disease, preexisting diabetes mellitus or preemptive transplants. Most patients were on CNI and steroid immunosuppression (n=209; 95%).The mean follow up post transplantation was 6.3 years.
The risk of acute cellular rejection was statistically significant in abroad group (13% vs 3%; p=0.005). However, the risk of ABMR or borderline rejections were similar. The incidence of post-transplant diabetes and malignancies was similar in both groups. There was no difference in 1-,3- and 5-year creatinine and proteinuria between both groups. Patient and graft survival rates were excellent in both groups and 5-year patient and death-censored graft survival rates in local and abroad groups were 100% vs. 93% and 95.2% vs. 96.6%, respectively.
Conclusion
Transition of care between countries carry its risks as it may be related to drug disruption or incomplete medical record. Kidney recipients transplanted abroad are at increased risk of acute cellular rejection; however, patient and graft survival rates remain excellent.