[Follow-up after renal transplantation].

Follow-up after renal transplantation is vital to improve allograft long-term survival and quality of life. This article describes the awareness, frequency, patterns, and contents of the follow-up after renal transplantation, especially 6 factors that may adversely influence the long-term survival of renal transplant recipients.

Prevalence and influential factors of erectile dysfunction in male renal transplant recipients: a multiple center survey.

BACKGROUND: Renal transplants can improve the quality of life for recipients, but the quality of their sexual life might not be improved. This study was conducted to research the prevalence of erectile dysfunction (ED) and the influential factors in male renal transplant recipients (RTRs). METHODS: A cross-sectional survey was conducted in three renal transplantation centers. Structured questionnaires were administrated by trained interviewers to 824 male renal transplant patients, who had active sexual lives in the last 6 months. RESULTS: Complaints of ED were reported by 75.5% of the 809 RTRs (age range 19 - 75 years, mean age (45 +/- 10) years), whose questionnaires were completed. Mild, moderate and severe ED were reported at 53.6%, 8.3% and 13.6%, respectively. The mean age and the graft duration were significantly higher in male RTRs with ED compared to potent graft recipients (P = 0.00 and 0.04, respectively). The prevalence of ED increased with the increase in age. It was 60.7%, 65.8%, 75.2%, 87.5% and 92.2% in patients with age below 30 years, 31 - 40 years, 41 - 50 years, 51 - 60 years and over 60 years, respectively (P = 0.000). Moreover, the severity of ED increased with aging. The percentage of moderate and severe cases of ED increased from 6.7% in patients below 40 years to 28.9% in those over 40 years (P = 0.000). The prevalence of ED in the RTR who had no occupation was higher than in those who were holding a position (P = 0.001). The prevalence of ED decreased with the increase in the education level. The prevalence of ED was 94.3%, 86.4%, 74.0% and 67.8% in men with elementary school or lower, middle school, high school, and college or higher degrees, respectively (P = 0.000). Patients, whose distal end of arteria iliaca interna was interrupted and underwent iterative transplantation, worried transplanted kidney function was impacted by sexual life, and received cyclosporine (CsA)-based immunosuppressive regimens, were more likely to have ED (P = 0.000, 0.001, 0.000, 0.000, respectively). After Logistic regression analysis, only five factors, age, education level, interruption of arteria iliaca interna distal end, worrying transplanted kidney function impacted by sexual life and CsA-based immunosuppressive regimens sustained their significance. CONCLUSIONS: Renal transplant has varying effects on erectile function. ED is highly prevalent among RTRs and its influential factors are multiple. Age, education level, interruption of arteria iliaca interna distal end, worrying transplanted kidney function impacted by sexual life, CsA-based immunosuppressive regimens are the main influential factors of ED in male RTRs.

[Necessity and safety of conversion from mycophenolate mofetil to AzA thioprine after renal transplantation].

OBJECTIVE: To investigate the necessity and safety of conversion from mycophenolate mofetil (MMF) to Azathioprine (AzA) in stable renal transplant patients. METHODS: In a randomised open clinical trial, A total of 87 low-risk renal allograft recipients on triple immunosuppressive therapy (prednisone/MMF/cyclosporine) 6 months after transplantation was randomised into two groups: converted (switching MMF to AzA treatment 6 months after transplantation, n = 42) and control (continued MMF treatment, n = 45). Renal function, acute rejection episodes, side effects and related complications were analysed in each group. RESULTS: The outcome (such as event-free graft survival rate and incidence of acute rejection) of treatment after a 12-months follow-up of patients in two groups was similar. Liver lesion and leukocytopenia, most of which was reversible, occurred more frequently in the converted than in the control group. CONCLUSION: Under the special economic atmosphere and medical insurance system of our country, the conversion from MMF to AzA in some renal transplant patients was necessary and safe. Further study is needed to evaluate the long-term outcome of this conversion.