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Kidney Week

Abstract: PO2148

Long-Term Outcomes of Kidney Transplantation in a Disadvantaged Population in Mexico

Session Information

Category: Transplantation

  • 1902 Transplantation: Clinical

Authors

  • Garcia-Guevara, Maria Fernanda, Hospital General de Mexico Dr Eduardo Liceaga, Ciudad de Mexico, Ciudad de Mexico, Mexico
  • Lima-Lucero, Jesus Daniel, Hospital General de Mexico Dr Eduardo Liceaga, Ciudad de Mexico, Ciudad de Mexico, Mexico
  • Perez-Navarro, L. Monserrat, Hospital General de Mexico Dr Eduardo Liceaga, Ciudad de Mexico, Ciudad de Mexico, Mexico
  • Valdez-Ortiz, Rafael, Hospital General de Mexico Dr Eduardo Liceaga, Ciudad de Mexico, Ciudad de Mexico, Mexico
Background

Access to kidney transplantation in Mexico was limited to patients with social security. Since 2010 at the Dr. Eduardo Liceaga General Hospital of Mexico, a kidney transplant program was established for patients with terminal chronic kidney disease living in extreme poverty or without social security. We aim was to analyzed patient survival, graft survival, post-kidney transplant complications, and modification of work status before and after transplantation were analyzed.

Methods

Case-control study nested in a cohort. Kidney transplant recipients who were in disadvantaged conditions from 2010 to 2020 were analyzed.

Results

During the study period, 345 transplants were performed. The median age was 31.5 ± 11.58 years, 58.6% were men and 74% of the transplants were from living donors. Ninety patients (26%) with social security (With SS) and 255 patients (74%) without social security (Without SS) at the time of transplantation were analyzed. The With SS patients presented mainly peritoneal dialysis as renal replacement therapy, while the Without SS patients on intermittent hemodialysis (p≦0.05). There were significant differences in immunosuppressive induction and maintenance schedules between groups. Patients Without SS more frequently received only steroids as induction therapy and cyclosporine as maintenance therapy (p≦0.05). A higher frequency of acute rejection and chronic rejection was observed in patients Without SS (p≦0.05). No differences were observed in metabolic, cardiovascular or infectious complications after transplantation. With an average follow-up of 6.23 ± years, not difference was identified in graft survival (With SS: 84.7% vs Without SS: 85.9%, p=0.222); nor in patient survival (88.5% versus 84.3%, p=0.105). When comparing the work status of patients without social security, a significant increase was observed in the work status at baseline and after kidney transplantation (23.7% vs 45.8%, p=0.001).

Conclusion

Access to kidney transplantation in Mexico is uneven and this is due to the fragmented health system in Mexico. A national kidney transplant program without inequities is required where the entire population has access to health services and their post-transplant follow-up.