Foundation, Chennai, in 1994 has made a significant contribution in this direction.[3] Even so, only two of total kidneys for renal transplantation are procured from deceased renal donors resulting from different reasons.[4-6] Deceased donor transplant program in our hospital started in 1998. In this retrospective study, we highlight our experience in promotion of this plan.Materials AND METHODSA retrospective evaluation from the records of 35 deceased donors and 44 renal transplant Telomerase list recipients from August 1998 to April 2011 was accomplished. Of those only 7 DDOT were doneIndian Journal of Urology, Apr-Jun 2013, Vol 29, IssueSwami, et al.: Deceased donor renal transplantation: Our experiancetill 2005. Our DDOT plan got accelerated from 2005 onward with cooptation of liver, cardiac, and corneal transplant plan along with a devoted transplant coordinator in the group. Ahead of 2010, certainly one of the two retrieved kidneys was shared with a further institute in the same city. Right after 2010, we are employing both in the retrieved kidneys in our institute. All recipients had been investigated for ESRD by the nephrologists within the Division of Nephrology and were then jointly evaluated by the integrated nephrology/urology team in the renal transplant plan. Our transplant plan includes expanded criteria donors (ECDs) for renal transplantation. ECDs were defined as per the United Network for Organ Sharing (UNOS). All donors older than 60 years or donors among 50 and 59 years with any two on the following were integrated: Hypertension, cerebrovascular lead to of brain death, or preretrieval serum creatinine (SCr) 1.five mg/dl.[7-9] All donors and recipients have been ABO compatible, and all recipients had a unfavorable donor T-cell cross-match. The donors were optimized in the ICU under the supervision of an intensivist. Organs were harvested on availability and preserved with cold histidine-tryptophan ketoglutarate (HTK) option. Transplantation was carried out as per standard methods. We routinely use DJ stent in our individuals. All recipients NOP Receptor/ORL1 Molecular Weight received sequential triple drug immunosuppression and induction with rabbit antithymocyte globulin (rATG). Calcineurin inhibitors were started on engraftment. Induction was commenced with steroid and rATG at a dose of 1.5 mg/kg. The first dose of rATG was given intraoperatively and subsequent rATG infusions were administered everyday for a minimum of five and maximum of 7 doses according to initial graft function. Maintenance immunosuppression consisted of tapering doses of steroids, mycophenolate mofetil (MMF), and tacrolimus (TAC). The administration of TAC was delayed until the patient had exhibited a brisk diuresis plus a declining SCr level (4.0 mg/dl). All patients received surgical web site prophylaxis having a third-generation cephalosporin for 72 h, starting just prior to the induction of anesthesia. Delayed graft function (DGF) was defined as a failure to decrease the SCr within 72 h or even a requirement for dialysis inside the initially week right after transplantation. Prolonged drainage was defined as extra than 50 ml of drainage right after postoperative day 7. Postoperative complications and rejection episodes have been noted. The diagnosis of renal allograft rejection was suggested by a decline in renal function confirmed by ultrasound-guided percutaneous allograft biopsy as per the modified Banff classification.[10,11] Cellular rejections had been treated with methyl prednisone (MP) 500 mg ?3-5 doses ?r-ATG 1.5 mg/kg single dose. Humoral rejections were treated with plasmaphere.
