ABSTRACT
Death with a functioning graft [DWF] has been reported as a major cause of graft loss after renal transplantation [R Tx]. Death with functioning has been reported to occur in 9 to 30%. From March 1976 to January 2001, a total of 1400 living donor renal transplants were performed in our center. Out of 257 reported deaths among our patients, 131 recipients died with functioning grafts after a mean period of 53.4 + 53.2 months. These DWF patients account for 27% of all graft losses in our series. The mean age was 34.9+10.6 [range, 8-62 ys], 98 of them were male and 33 were female. The original kidney disease was GN in 9, PN in 24, PCK in 5 and nephrosclerosis in 8 patients. Acute rejection episodes were diagnosed in 84 patients [63.1]. The posttransplant complications encountered were hypertension in 78 patients [59.5%], diabetes mellitus in 30 patients [22.9%], medical infections in 68 [51.5%], hepatic complications in 30 [22.9%] and malignancy in 17 patients [13%]. The main causes of death in these patients were infections in 46 [35.6%], cardiovascular in 23 [17.6%], liver cell failure in 15 patients [11.4%] and malignancy in 8 [6.1%]. The mean serum creatinine was 2 + 0.6 mg/dl at last follow up before death. We conclude that the survival of transplant recipients is significantly lower than age-matched controls in the general population. The relatively higher mortality in RTx is, in part, due to comorbid medical illness, pretransplant dialysis treatment, and factors uniquely related to transplantation, including immunosuppression and another drug effects