Survival outcomes in renal transplantation in Trinidad and Tobago: SORTTT study.

OBJECTIVE: To assess patient and graft survival outcomes of renal transplant recipients from the National Organ Transplant Unit, Trinidad and Tobago. DESIGN AND METHODS: A retrospective descriptive analysis of renal transplants performed within five and half years (January 2006-June 2011) at the National Organ Transplant Unit was conducted. The age, gender ethnicity, cause of renal failure, donor type, outcome and complications were examined. The one, two and three-year patient and graft survival rates were analysed and factors affecting them were discussed. RESULTS: A total of 73 renal transplantations were done. Seventy (95.9%) were from live donors and 3 (4.1%) from deceased donors. Thirty-eight patients (52.1%) were males and 35 (47.9%) were females. The one-year, two-year and three-year patient survival rates were 91.46% (SE 0.04), 89.51% (SE 0.04) and 86.31% (SE 0.05), respectively. The one-year graft survival rate was 94.34% (SE 0.03). The two-year and three-year graft survival rates were the same at 92.69% (SE 0.03). The most significant complications seen in the recipients were those related to infections and cardiovascular disease: 47.9% of patients had a urinary tract infection, with the majority occurring at twelve months and 32.5% developed dyslipidaemia for the first time at six months. Seven patients developed erythrocytosis. CONCLUSION: The patient and graft survival rates in this new transplant programme are acceptable. Complications which can occur in transplant recipients are common and have a significant impact on post-transplantation quality of life and survival. Thus, continuing assessment of co-morbid factors pre and post-transplantation as well as the analysis of donor and recipient factors will lead to an increase in both patient and graft survival.

Survival outcomes in renal transplantation in Trinidad and Tobago - SORTTT study / Resultados de la supervivencia de transplante renal en Trinidad y Tobago - estudio RSTRTT

OBJECTIVE: To assess patient and graft survival outcomes of renal transplant recipients from the National Organ Transplant Unit, Trinidad and Tobago. DESIGN AND METHODS: A retrospective descriptive analysis of renal transplants performed within five and half years (January 2006 - June 2011) at the National Organ Transplant Unit was conducted. The age, gender, ethnicity, cause of renal failure, donor type, outcome and complications were examined. The one, two and three-year patient and graft survival rates were analysed and factors affecting them were discussed. RESULTS: A total of 73 renal transplantations were done. Seventy (95.9%) were from live donors and 3 (4.1%) from deceased donors. Thirty-eight patients (52.1%) were males and 35 (47.9%) were females. The one-year, two-year and three-year patient survival rates were 91.46% (SE 0.04), 89.51 % (SE 0.04) and 86.31% (SE 0.05), respectively. The one-year graft survival rate was 94.34% (SE 0.03). The two-year and three-year graft survival rates were the same at 92.69% (SE 0.03). The most significant complications seen in the recipients were those related to infections and cardiovascular disease: 47.9% of patients had a urinary tract infection, with the majority occurring at twelve months and 32.5% developed dyslipidaemia for the first time at six months. Seven patients developed erythrocytosis. CONCLUSION: The patient and graft survival rates in this new transplant programme are acceptable. Complications which can occur in transplant recipients are common and have a significant impact on post-transplantation quality of life and survival. Thus, continuing assessment of comorbid factors pre and post-transplantation as well as the analysis of donor and recipient factors will lead to an increase in both patient and graft survival.

OBJETIVO: Evaluar los resultados de supervivencia de pacientes y transplantes en relación con recipientes de transplante renal en la Unidad Nacional de Trasplante de Órganos de Trinidad y Tobago. DISEÑO Y MÉTODOS: Se realizó un análisis descriptivo retrospectivo de trasplantes renales de cinco años y medio (enero de 2006 - junio de 2011) en la Unidad Nacional de Trasplantes de Órganos. Se examinó la edad, el género, la etnicidad, la causa de la insuficiencia renal, el tipo de donante, la evolución clínica del paciente, y las complicaciones. Se analizaron las tasas de supervivencia de pacientes y transplantes, de uno, dos y tres años, y se discutieron los factores que las afectan. RESULTADOS: Se realizaron un total de 73 trasplantes renales. Setenta (95.9%) fueron de donantes vivos, y tres (4.1%) de donantes muertos. Treinta y ocho pacientes (52.1%) eran varones y 35 (47.9%) eran hembras. Las tasas de supervivencias de uno, dos y tres años relativas a los pacientes, fueron 91.46% (SE 0.04), 89.51% (SE 0.04) y 86.31% (SE 0.05), respectivamente. La tasa de supervivencia de transplante de un año fue 94.34% (SE 0.03). Las tasas de supervivencia de transplante de dos y tres años fueron iguales, alcanzando un 92.69% (SE 0.03). Las complicaciones más significativas observadas en los recipientes fueron las relacionados con infecciones y la enfermedad cardiovascular: 47.9% de los pacientes tenían infección de las vías urinarias, teniendo lugar la mayoría de ellas a los doce meses, en tanto que el 32.5% desarrolló dislipidemia por primera vez a los seis meses. Siete pacientes desarrollaron eritrocitosis. CONCLUSIÓN: Las tasas de supervivencia de pacientes y transplantes en este nuevo programa de trasplante son aceptables. Las complicaciones que pueden ocurrir en los recipientes son comunes y tienen un impacto significativo en la calidad de vida postransplante. Por lo tanto, continua evaluación de los factores comórbidos pre- y postransplante, así como el análisis de donantes y recipientes conducirá a un aumento de la supervivencia, tanto de los pacientes como de los transplantes.

Trends in HIV/TB coinfection in Trinidad and Tobago for the period 1998-2007.

OBJECTIVES: The aim of this study was to extend the description of the epidemiologic pattern of human immunodeficiency virus (HIV)/tuberculosis (TB) coinfection from 1998 to 2007 in a high HIV/AIDS prevalence country. DESIGN AND METHODS: This study utilized registry data to determine yearly TB incidence and HIV coinfection. Mortality rates for coinfected patients were calculated and compared with patients receiving highly active antiretroviral therapy (HAART). RESULTS: From a TB population of 2010 registered patients, data was collected on the 466 patients with HIV/TB coinfection. The coinfection rate was found to be 23.6% for the study period. Patients on HAART were twice as likely to survive. DISCUSSION AND CONCLUSIONS: The incidence of TB and HIV/TB coinfection rates continues to be major challenges in the developing world. Demographic, socioeconomic trends as well as risk factors remain unchanged. Increased HIV screening and HAART coverage offers hope for the future.