Results
In this study, the data of 211 patients who underwent kidney
transplantation between September 2012 and September 2019 were
retrospectively evaluated. The median and interquartile range (IQR) of
age and time from kidney transplantation of patients was 32 years (22-42
years) and 48,9 months (26,2-71 months) respectively. Median and IQR
follow-up time for ARD-DJS and St-DJS patients was 72 months (62,5-80,3
months) and 27,8 months (17,4-39,6 months) respectively.
Seventy patients (33,1%) underwent preemptive kidney transplantation.
Basiliximab was used in 66 patients (31,3%) and ATG was used in 130
patients (61,6%) as induction therapy. Fifteen patients (7,1%) were
not given induction therapy. Three cases used cyclosporin+MMF+
prednisolone, eight cases used everolimĀus+tacrolimus+prednisolone, and
all other patients used tacrolimus+MMF+prednisolone for mainteĀnance
immunosuppression. Acute rejection was observed in 13 patients, humoral
rejection in 3 patients, humoral, and cellular rejection in 3 patients.
In 6 patients, graft loss due to rejection was observed (CR:3 HR:2
CR+HR: 1 patient). In postoperative duration DGF was observed in 9
patients (4,2%), graft loss was observed in 12 patients (5,7%). DJS
was used in all patients, ARD-DJS was used in 100 patients (47,4).
Thirteen patients (6,1%) had BKV viremia. BKV was revealed by kidney
biopsy in 3 of 13 patients. However, graft loss due to BKVN was observed
in only one patient. Except for 2 patients viremia was observed in the
first 3 months in these patients, while in the other 2 patients, viremia
was observed at 12 and 84 months after transplantation respectively.
These 2 patients were in the group of ARD-DJS, in 4 of 13 patients with
BKV, ARD-DJS, and in 9 patients st-DJS was used. Patients in whom BKV
revealed in the first 3 months were compared in the aspect of DJS
technique, BKV was significantly less observed in the ARD-DJS group
(ARD-DJS: 2 patients; St-DJS:9 patients), (p=0,046). St-DJS was used in
6 of 7 patients with viremia level>10,000, however, this
finding was not statistically significant. When the patients were
compared according to their final blood creatinine levels, the
creatinine levels in patients with st-DJS and ARD-DJS was 1,19 (range
0,96-1,47) and 1,03 (range 0,86-1,27) respectively which was
statistically significant (p=0,002). None of the patient groups had
urinary leakage in the postoperative period. However, in one patient in
each group, urinary stenosis was observed in the postoperative follow-up
period and revision operation was performed.