Research

Favourable outcomes for the first 10 years of kidney and pancreas transplantation at Wits Donald Gordon Medical Centre, Johannesburg, South Africa

June Fabian, Heather Maher, Alison Bentley, Petra Gaylard, Kim Crymble, Belinda Rossi, Lou Aucamp, Errol Gottlich, Jerome Loveland, J Rene Botha, Jean Botha, Russell Britz

Abstract


Background. It is important for centres participating in transplantation in South Africa (SA) to audit their outcomes. Wits Donald Gordon Medical Centre (WDGMC), Johannesburg, SA, opened a transplant unit in 2004. The first 10 years of kidney and pancreas transplantation were reviewed to determine outcomes in respect of recipient and graft survival.

Methods. A retrospective review was conducted of all kidney-alone and simultaneous kidney-pancreas (SKP) transplants performed at WDGMC from 1 January 2004 to 31 December 2013, with follow-up to 31 December 2014 to ensure at least 1 year of survival data. Information was accessed using the transplant registers and clinical records in the transplant clinic at WDGMC. The Kaplan-Meier method was used to estimate 1-, 5- and 10-year recipient and graft survival rates for primary (first graft) kidney-alone and SKP transplants.

Results. The overall 10-year recipient and graft survival rates were 80.4% and 66.8%, respectively, for kidney-alone transplantation. In the kidney-alone group, children tended towards better recipient and graft survival compared with adults, but this was not statistically significant. In adults, recipient survival was significantly better for living than deceased donor type. Recipient and graft survival were significantly lower in black Africans than in the white (largest proportion in the sample) reference group. For SKP transplants, the 10-year recipient survival rate was 84.7%, while kidney and pancreas graft survival rates were 73.1% and 43.2%, respectively.

Conclusion. Outcomes of the first 10 years of kidney and pancreas transplantation at WDGMC compare favourably with local and international survival data.


Authors' affiliations

June Fabian, Wits Donald Gordon Medical Centre, Johannesburg, South Africa; Department of Internal Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa

Heather Maher, Wits Donald Gordon Medical Centre, Johannesburg, South Africa

Alison Bentley, Wits Donald Gordon Medical Centre, Johannesburg, South Africa; Department of Family Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa

Petra Gaylard, DMSA (Data Management and Statistical Analysis), Johannesburg, South Africa

Kim Crymble, Wits Donald Gordon Medical Centre, Johannesburg, South Africa

Belinda Rossi, Wits Donald Gordon Medical Centre, Johannesburg, South Africa

Lou Aucamp, Wits Donald Gordon Medical Centre, Johannesburg, South Africa

Errol Gottlich, Wits Donald Gordon Medical Centre, Johannesburg, South Africa; Morningside Mediclinic, Johannesburg, South Africa

Jerome Loveland, Wits Donald Gordon Medical Centre, Johannesburg, South Africa; Department of Paediatric Surgery, Chris Hani Baragwanath Academic Hospital and Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa

J Rene Botha, Wits Donald Gordon Medical Centre, Johannesburg, South Africa

Jean Botha, Wits Donald Gordon Medical Centre, Johannesburg, South Africa

Russell Britz, Wits Donald Gordon Medical Centre, Johannesburg, South Africa

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Keywords

Transplant; Kidney; Pancreas; Survival

Cite this article

South African Medical Journal 2016;106(2):172-176. DOI:10.7196/SAMJ.2016.v106i2.10190

Article History

Date submitted: 2015-10-09
Date published: 2016-01-07

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