200 KIDNEY TRANSPLANTATION IN TUZLA

BOSNIA AND HERZEGOVINA

Enisa Mešić, UKC Tuzla

Nefrološka škola

Tešanj, 06.10.2018.

Tuzla

1990

2006

2016

FBIH - KIDNEY TRANSPLANTATION 2015-2018

6

10 0

4

0

21

10

12

1

8

5

7 76 6 6

44

8

23

1819

1514

0

2

4

6

8

10

12

14

16

18

20

2015 2016 2017 2018

Sarajevo

LRD

Sarajevo

KTx

Sarajevo

ukupno

Tuzla

LRD

Tuzla

URLD

Tuzla

Ktx

Tuzla

ukupno

1999

2006

0

20

40

60

80

100

120

140

160

1999-2005 2006-2012 2012-2018 1999-2018

LRD

URLD

KTx

KIDNEY TRANSPLANTATION IN TUZLA 1999-2018

LRD

68%

URLD

16%

Ktx

16%

1999-2018

LRD

98%

URLD

2%

Ktx

0%

1999-2005

LRD

69%

URLD

9%

Ktx

22%

2006-2012

LRD

48%

URLD

28%

Ktx

24%

2013-2018

14

2

12

1

Deceased donors

Tuzla Sarajevo Zenica Banja Luka

AGE AND GENDER STRUCTURE OF RECIPIENTS AND DONORS

Tuzla LRD URLD Deceased

Average age of

recipients

32.6 years (12-72) 47.4 (22-69) 36.4 years (26-68)

Female recipients 49 (36.0.3%) 10 (34.48%) 15 (42.86%)

Male recipients 87 (63.98%) 19 (65.52%) 20 (57.14%)

Dialysis 33 (1-264) months 42 (13-166) 70 (1-170)

Average age of donors

49.53 years (25-72) 47.52 (21-71) 48.06 (25-65)

LIVING RELATED AND UNRELATED DONORS

Tuzla LRD URLD

Mothers 46 (33.82%)

Fathers 33 (24.26%)

Sisters 24 (17.65%)

Brothers 23 (16.91%)

Others 10 (7.35%)

Wives 14 (48.28%)

Husbands 10 (34.48%)

Others 5 (17.24%)

12 younger than 18 years

PRIMARY KIDNEY DISEASE

51%

3%5%

11%

18%

12%

GN DM PN Reflux NN Ostalo

IMUNOSUPPRESIVE THERAPY

• 1999 – 2002• ATG + triple IS therapy (KS, azathioprine,

cyclosporin)

• 2002 – 2017 • Basiliximab + triple IS (KS, MMF, cyclosporin)

• 2006 – 2017• Tacrolimus 50% bolesnika• Advagraf (2016)

• 2011-2018• Generics

ACUTE REJECTION AND DELAYED GRAFT FUNCTION DURING THE FIRST POST-TRANSPLANTATION YEAR

Acute rejection Delayed graft function Primary graft afunction Normal graft function

Ktx (35) 4 6 2 19

URLD (29) 5 3 1 20

LRD (136) 17 5 4 110

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

LRD (136) URLD (29) Ktx (35)

EARLY SURGICAL COMPLICATIONS, INFECTIONS AND CARDIOVASCULAR INCIDENTS DURING THE FIRST POST-

TRANSPLANTATION YEAR

LRD (136) URLD (29) Ktx (35)

CVD 4 2 3

Infections 14 5 9

Early surgical complications 22 7 8

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Early surgical complications Infections CVD

HCV + RECIPIENTS

88%

6%6%

Ukupno

antiHCV +

Liječeni

17

5 YEARS OVERAL GRAFT AND PATIENTS SURVIVAL

0 02

16

1 1

76

5

9

LRD (92) URLD (6) Ktx (12)

0

10

20

30

40

50

60

70

80

Lethal outcome Dialysis Functioning graft

82,6%

83,3 %

75,0 %

Nedovoljno dobro

• Dijagnostika moždane smrti i broj organa od umrlih osoba

• Lista čekanja

• Federalni transplant centar

• Imunološka dijagnostika

• Organizacija transplantacije u BiH

DA

• Žive rodbinske transplantacije bubrega

• Žive nerodbinske transplantacije bubrega (rodbina i tazbina)

• Transplantacije bubrega u visoko-rizičnih i senzibiliziranih bolesnika

• Transplantacije bubrega od umrlih osoba

• Besplatno za osiguranike u FBIH

NE

• ABO inkompatibilne transplantacije bubrega

• Altruistični donori

• Uparene transplantacije

Tuzla

1999 - 2019