Preliminary results of pilot program for renal transplantation Cayetano Heredia National Hospital, Ministry of Health, Lima, Peru

• Autores: Zegarra Montes, Luis, Loza Munarriz, Reyner, Medina Ninacóndor, Raúl, Melgarejo Zeballos, Weymar, Del Castillo Mory, Alfonso, Sánchez Chipana, Roberto, Valenzuela Córdova, Raúl, Vásquez Flores, Luciola, Parvina De la O, Gessica, Coa Alcocer, Edgar, Cieza Terrones, Michael, Pari Bravo, Marlene, Loza Munarriz, César
• Formato: artículo
• Fecha de Publicación: 2010
• Institución: Colegio Médico del Perú
• Repositorio: Acta Médica Peruana
• Lenguaje: español
• OAI Identifier: oai:amp.cmp.org.pe:article/1382
• Enlace del recurso: https://amp.cmp.org.pe/index.php/AMP/article/view/1382
• Nivel de acceso: acceso abierto
• Materia: Insuficiencia renal; diálisis; trasplante de riñón; niños; Renal Insufficiency; díalysis; kidney transplantation; child

Introduction: The Integral Health Insurance started a support program to finance renal replacement therapies. Objetive: We present preliminary results of the Pilot Program Renal Transplantation of Cayetano Heredía National Hospital – Public Health. Material and method: Case series of renal transplantation period 2007 to 2009. Results: we performed 32 living-related donor 30 (93.75%), unrelated 1 (3.13%), cadáver 1 (3.13%), 14 (43.75%) men, 18 (56.25%) women, 18 (56.25%) children and 14 (43.75%) adults. The average age was 21.5 ± 12.14 years (9.3 – 65.3), average waiting time on díalysis was 2.04 ± 1.79 (0.3 – 6.36) years. Time of arterial and venous anastomosis, warm ischemia and cold was 32.28 ± 15.52 (15-79) min, 31 ± 9.7 (20 - 60) min, 1.72 ± 1.02 (0.83 – 3.28) min, 2.5 ± 0.56 (1 – 16) hours respectively. Induction therapy it was Antithymocyte Globulin in 20 cases and maintenance therapy: it was Tacrolimus, Cyclosporine, mycophenolate mofetil and prednisone. Surgical complications: lymphocele (4), lymphatic leakage (1), ureteral fistula (1), primary anastomosis failure with double renal artery (1) and arterial thrombosis (1). Medical: urinary tract infection (12), acute tubular necrosis (5), acute rejection (6), nephrotoxicity (2), recurrence of primary disease (1) and AH1N1 pneumonia (1). The mean time of follow-up was: 11.25 ± 7.03 (2.4 – 27.4) months; the glomerular filtration rate average is 76.47 ± 22.52 (30 – 140) ml/min./1.73 m2sc. Conclusion: Renal transplantation in a public hospital is feasible with good results comparable to international standards, implementing a public health financing program and targeting poor populations and in extreme poverty.