Abstract
Objectives: In August 2004, a national organ transplant program utilizing the latest policies, procedures, and protocols was begun in Libya. During the first year of the program, 50 kidney transplantations from living donors were performed. Materials and Methods: Forty-nine patients (aged 7 to 65 years) received kidneys from living-related donors (aged 19 to 54 years), and 1 husband received a kidney from his wife. Donor selection was based on human leukocyte antigen compatibility. Renal failure was due to chronic glomerulonephritis in most patients, diabetes in 5 adults, systemic lupus erythematosus in 2 adults, and congenital anomalies in 2 children. Sixteen patients matched the human leukocyte antigens of their donors, 28 matched 1 haplotype, and 6 did not match any haplotype. Immunosuppression was accomplished with methylprednisolone and basiliximab. Maintenance therapy was with mycophenolate mofetil, cyclosporine, and prednisone. The latter was completely discontinued 1 month after transplantation. In patients with resistant hypertension, unilateral native nephrectomy was carried out during transplantation. Donor nephrectomy was performed through an open miniincision using a Thompson retractor. Results: At the time of this writing, 49 patients are alive and well, and 48 of them have had functioning kidneys for 10 to 22 months. Three patients had acute rejections that were successfully treated with methylprednisolone (n = 1) or methylprednisolone and antithymocyte globulin (n = 2). At the time of this writing, all 46 adults and 2 pediatric recipients 1Organ Transplant Center, Tripoli Central Hospital, Tripoli, Libya 2Department of Surgery, Drexel University Medical College, Philadelphia, PA, USA Address reprint requests to: George M Abouna, MD, MS, FRCS(C), FACS, 734 Woodcrest Road, Radnor, PA, 19087 USA Phone: 00 610-688-6871 Fax: 00 610-964-8571 E-mail: [email protected] Experimental and Clinical Transplantation (2006) 1: 425-428 Copyright © Başkent University 2006 Printed in Turkey. All Rights Reserved. have excellent renal function and are living normal lives. Conclusions: In terms of patient survival and quality of life, transplantation is superior to dialysis. Also, transplantation is less expensive than dialysis. In Libya, establishing an active and successful transplant program with early steroid withdrawal has brought many benefits to patients and their families and great financial savings to the government. Our program hopefully will provide a model for similar programs in Asia and Africa and encourage local governments to legalize organ procurement from cadaveric donors.