Deceased donor renal transplantation and the disruptive effect of commercial transplants: the experience of Oman.

The Oman Renal Transplantation Program was established in 1988 as a joint venture between Sultan Qaboos University and the Ministry of Health. It began with both living related donor (LRD) and deceased donor (DD) transplants. Over the next nine years, while the LRD programme progressed relatively well, there were only thirteen DD transplants. Two of the DD kidneys were obtained from overseas via an active collaboration with the Euro-transplant organisation, and one DD kidney was obtained from Saudi Arabia within the Gulf Cooperative Council exchange programme. The rest of the DD kidneys were obtained in Oman. The Omani DD programme, although it was a pioneering effort in the Gulf region at the time, was not entirely sustainable. In this paper we focus on the challenges we encountered. Among the major challenges was the absence of resources to establish a dedicated DD programme and particularly the failure to develop a cadre of dedicated transplant coordinators.

Donor gender balance in a living-related kidney transplantation program in Oman.

It has been observed in several Eastern and Western countries that there is a gender imbalance among kidney donors. In the international experience, approximately 65% of live kidney donors have been women. We retrospectively studied the distribution of female and male donors or recipients among living kidney transplantations performed from 1980 to 2005, namely 198 Omani recipients of living-related kidney transplantations. To examine cultural influences, transplantations performed or expatriates were excluded from the study. For the whole period, 98 out of 198 donors (49.5%) were women. The number of female recipients 75 of 198 (38%) versus males were 123 (62%) recipients. We then subdivided the period into three intervals: 1980 to 1990, 1991 to 2000, and 2001 to 2005. The numbers of female donors for these three periods were 29 of 64 (45%), 42 of 89 (47%), and 27 of 45 (60%), respectively. There was a persistent preponderance of male recipients ranging from 58% to 66% during these periods. We concluded that there was no gender imbalance for kidney donors. Nevertheless, there was a male preponderance in the recipient group.

Hepatitis B, delta and human immunodeficiency virus infections among Omani patients with renal diseases: A seroprevalence study.

The prevalence of hepatitis B virus (HBV), hepatitis delta virus (HDV), and human immunodeficiency virus (HIV) infections were determined in 102 patients on regular hemodialysis, 82 kidney recipients and 1030 nondialyzed, nontransplanted patients with various renal diseases. The prevalence rates of hepatitis B surface antigen (HBsAg) in dialysis and renal transplant patients (12.7% and 11.0% respectively) were significantly higher than the rate in a control group of patients who had never been dialyzed nor transplanted (2.9%, P<0.05). In patients who were HBsAg positive, evidence of HDV infection was found in one dialysis and two transplant patients only. HIV infection was confirmed in only two of 102 (2.0%) and three of 82 (3.7%) hemodialysis and kidney recipients respectively. These data indicate hepatitis B, delta and HIV infections are major health problems among hemodialysis and renal transplant patients in the Sultanate of Oman.

Prevalence of hepatitis B, hepatitis delta, and human immunodeficiency virus infections in Omani patients with renal diseases.

PIP: Patients treated at the Royal Hospital in Oman during January-June 1991 were divided in 3 groups. The 1st group included 103 patients (49 males, 54 females, with a mean of 39 years) who attended the Nephrology Clinic and none of whom were on dialysis. In the 2nd group there were 102 patients (46 males, 56 females, with a mean age of 42 years) on regular hemodialysis (with a mean duration of 35 months) because of end-stage renal failure. The 3rd group comprised 82 kidney transplant patients (44 males, 38 females, with a mean age of 33 years) with a mean duration of prior hemodialysis of 9 months in 80 patients. Blood serum samples from all patients as well as from 134 medical students and 564 blood donors were tested for hepatitis B surface antigen (HBsAg) and hepatitis B core antibody (anti-HBc) by enzyme-linked immunosorbent assay. HBsAg-positive samples were tested for antigen and antibody to hepatitis delta virus (HDV). The prevalence of HBsAg was significantly higher in hemodialysis and renal transplant patients than in nephrology clinic patients (P .05). Previous exposure to HBV was found in 48 of 103 (46.6%) nephrology clinic patients, in 53 of 102 (52%) hemodialysis patients, and in 43 of 82 (52.4%) renal transplant patients. Anti-HBc prevalence rates were significantly lower in medical students (23.1%) and blood donors (27%) than in the patient groups (P .001). In HBsAg-positive subjects HDV infection was found in 1 of 13 (7.7%) patients on dialysis and 2 of 9 (22.2%) kidney transplant recipients who had been transfused in the past. A double infection of HBV and HCV was found only in 4 hemodialysis and 2 transplant patients among 287 patients and 698 healthy subjects tested. Among 5 HIV-infected patients 3 transplant patients seroconverted between 3 and 7 months after kidney transplantation abroad; and 2 hemodialysis patients seroconverted after repeated dialysis and multiple blood transfusions used for kidney transplantation abroad.^ieng