Please wait a minute...
Search Asian J Urol Advanced Search
Share 
Asian Journal of Urology, 2019, 6(4): 305-311    doi: 10.1016/j.ajur.2019.02.003
  本期目录 | 过刊浏览 | 高级检索 |
Kidney transplantation in Indonesia: An update
Tommy Supita,Eriawan Agung Nugrohob*(),Ardy Santosab,Moh Adi Soedarsob,Nanda Daniswarab,Sofyan Rais Addinb
a Department of General Surgery, Faculty of Medicine Diponegoro University, Dr. Kariadi General Hospital, Semarang, Jawa Tengah, Indonesia
b Department of Urology, Faculty of Medicine Diponegoro University, Dr. Kariadi General Hospital, Semarang, Jawa Tengah, Indonesia
下载:  HTML  PDF (977KB) 
输出:  BibTeX | EndNote (RIS)      
服务
把本文推荐给朋友
加入引用管理器
E-mail Alert
RSS
作者相关文章
Abstract: 

Objective: Indonesia has overcome several barriers to the growth of kidney transplantation within the past decade. Currently, the procedure is increasingly performed in several centers across the country. However there are limited publications on kidney transplantation from Indonesia, especially from centers outside Jakarta. This study aims to give a brief overview on transplantation performed, discuss current efforts and progresses of transplantation in Indonesia and chiefly Semarang. Methods: Retrospective analysis of 20 transplant cases in Semarang during 2014-2018 was performed. Information from other transplant centers was acquired through formal correspondences with 11 central teaching hospitals in Jakarta, Surabaya, Yogyakarta, Malang, Bali, Solo, Palembang, Aceh, Medan, Bandung, and Padang. Results: There were 629 recorded kidney transplantations performed in 12 centers, and we report on 245 cases with viable data. The average age of kidney recipients were younger (35.4 years old) compared to the donors (41.3 years old). Approximately half of the kidneys were obtained from related donors (49.0%) and there was only one case of cadaveric donor. The three leading etiologies of end-stage renal disease were hypertension (37.4%), diabetes mellitus (26.1%), and autoimmune disease (11.3%). There is only one center that has performed more than 100 kidney transplants in Indonesia. Conclusion: Indonesia has successfully overcome several major hurdles that had previously hindered the growth of transplantation. Further improvement should concentrate on the development of integrated organ transplant infrastructure, decentralization of transplant professionals, establishment of National kidney transplant database and changing the Nation's paradigm on cadaveric organ donor through public education.

Key words:  Kidney transplantation    End-stage renal disease    Chronic kidney disease    Indonesia    Semarang    Epidemiology    Update
收稿日期:  2018-06-11      修回日期:  2018-10-31      接受日期:  2018-12-06      出版日期:  2019-02-22      发布日期:  2019-09-23      整期出版日期:  2019-10-20
引用本文:    
. [J]. Asian Journal of Urology, 2019, 6(4): 305-311.
Tommy Supit,Eriawan Agung Nugroho,Ardy Santosa,Moh Adi Soedarso,Nanda Daniswara,Sofyan Rais Addin. Kidney transplantation in Indonesia: An update. Asian Journal of Urology, 2019, 6(4): 305-311.
链接本文:  
http://www.ajurology.com/CN/10.1016/j.ajur.2019.02.003  或          http://www.ajurology.com/CN/Y2019/V6/I4/305
Characteristic Value
Age, mean (range), year
Recipient (n = 26) 33.0 (15-50)
Donor (n = 26) 46.1 (24-64)
Sex, male/female
Recipient (n = 26) 18/8
Donor (n = 26) 15/11
Donor-recipient relationship, n (%)
Related 19 (73.0)
Non-related 7 (27.0)
Etiology of ESRD, n (%)
Hypertension 16 (61.5)
Diabetes mellitus 3 (11.5)
Autoimmune 1 (3.9)
Glomerulonephritis 2 (7.7)
Other 4 (15.4)
Recipient comorbidities, n (%)
Coronary artery disease 3 (17.6)
Cerebrovascular disease 3 (17.6)
Pulmonary tuberculosis 2 (11.8)
Pleural effusion 2 (11.8)
Ascites 2 (11.8)
Hepatitis C 2 (11.8)
Gastric erosion 2 (11.8)
Depression 1 (5.8)
HLA Matching, n (%)
Full match 20 (76.9)
4 miss match 1 (3.8)
3 miss match 1 (3.8)
2 miss match 2 (7.7)
1 miss match 2 (7.7)
Number of transplant, n
In 2014 4
In 2015 3
In 2016 5
In 2017 8
In 2018 6
Mortality (%)
In 2015 33.3 (1/3)
In 2016 40.0 (2/5)
In 2017 0 (0/8)
In 2018* 0 (0/6)
Procedural time, mean, min
Cold ischemic time 8.1
Warm ischemic time II 27.9
Total ischemic time 36.9
Complications and outcome
Mean intraoperative bleeding, mean ± SD, mL 384 ± 192
Recipient mean hospital stay, mean (range), day 11 (10-14)
Infection, n (%) 2 (7.7)
Cardiovascular, n (%) 3 (11.5)
Total number of deaths, n (%) 5 (19.2)
Redialysis, n (%) 3 (11.5)
Retransplant, n (%) 0 (0.0)
  
  
Characteristic Value
Age, mean (range), year
Recipient (n = 245) 35.4 (15-57)
Donor (n = 245) 41.3 (17-64)
Age groupa, recipient/donor, year
≤20 6/3
21-30 33/19
31-40 29/25
41-50 32/35
51-60 8/21
≥60 0/4
Sex, male/female
Recipient (n = 245) 161/84
Donor (n = 245) 136/109
Donor-recipient relationship, n (%)
Related 120 (49.0)
Unrelated 125 (51.0)
Kidney source, n (%)
Living donor 244 (99.6)
Cadaveric donor 1 (0.4)
Etiology of ESRDb, n (%)
Hypertension 76 (37.4)
Diabetes mellitus 53 (26.1)
Autoimmune 23 (11.3)
Glomerulonephritis 30 (14.8)
Other 21 (10.3)
Number of transplant performed, number of centers
<10 7
10-50 4
>50 1
  
[1] Prodjosudjadi W . Incidence, prevalence, treatment and cost of end-stage renal disease in Indonesia. Ethn Dis 2006;16(2 Suppl. 2). S2-14-6.
[2] Hill NR, Fatoba ST, Oke JL, Hirst JA, O’Callaghan CA, Lasserson DS , et al. Global prevalence of chronic kidney diseaseda systematic review and meta-analysis. PLoS One 2016;11:e0158765.
[3] Tonelli M, Wiebe N, Knoll G, Bello A, Browne S, Jadhav D , et al. Systematic review: kidney transplantation compared with dialysis in clinically relevant outcomes. Am J Transplant 2011; 11:2093-109.
[4] Yoo KD, Kim CT, Kim MH, Noh J, Kim G, Kim H , et al. Superior outcomes of kidney transplantation compared with dialysis: an optimal matched analysis of a national population-based cohort study between 2005 and 2008 in Korea. Medicine (Baltim) 2016;95:e4352.
[5] Markum HM . Renal transplantation problem in Indonesia. Acta Med Indones 2004; 36:184-6.
[6] Bennett PN, Hany A . Barriers to kidney transplants in Indonesia: a literature review. Int Nurs Rev 2009; 56:41-9.
[7] Mochtar CA, Alfarissi F, Soeroto AA, Hamid ARAH, Wahyudi I, B.H M , et al. Milestones of kidney transplantation in Indonesia. Med J Indones 2017; 26:229-36.
[8] Afiatin, Khoe LC, Kristin E, Masytoh LS, Herlinawaty E, Werayingyong P , et al. Economic evaluation of policy options for dialysis in end-stage renal disease patients under the universal health coverage in Indonesia. PLoS One 2017;12:e0177436. 0177436.
[9] The Indonesian Renal Registry Team. 8th report of Indonesian renal registry. 2015 [Accessed 1 May 2018],
[10] Marcelino A, Mochtar CA, Wahyudi I, Hamid AR . Kidney transplantation: a new era of laparoscopic living donor nephrectomy in Indonesia. Asian J Surg 2018; 41:55-8.
[11] Marbun MBH, Umami V, Susalit E . A 3-year survival rate of kidney transplant recipient in Cipto Mangunkusumo General Hospital in Indonesia. J Ren Med 2017; 1:1-5.
[12] Noppakun K, Ingsathit A, Pongskul C, Premasthian N, Avihingsanon Y, Lumpaopong A , et al. A 25-year experience of kidney transplantation in Thailand: report from the Thai Transplant Registry. Nephrology 2015; 20:177-83.
[13] Chan-On C, Sarwal MM . A comprehensive analysis of the current status and unmet needs in kidney transplantation in Southeast Asia. Front Med (Lausanne) 2017; 4:84.
[14] Prodjosudjadi W, Suhardjono A . End-stage renal disease in Indonesia: treatment development. Ethn Dis 2009; 19(1 Suppl. 1). S1-33-6.
[15] Perovic S, Jankovic S . Renal transplantation vs. hemodialysis: cost-effectiveness analysis. Vojnosanit Pregl 2009; 66:639-44.
[16] Haller M, Gutjahr G, Kramar R, Harnoncourt F, Oberbauer R . Cost-effectiveness analysis of renal replacement therapy in Austria. Nephrol Dial Transplant 2011; 26:2988-95.
[17] Indonesian Ministry of Health. Peraturan Menteri Kesehatan Republik Indonesia Nomor 52 Tahun 2016 Tentang Standar Tarif Pelayanan Kesehatan Dalam Penyelenggaraan Program Jaminan Kesehatan [accessed 02 May 2018].
[18] Toh S, Chan M . Universal Healthcare Coverage in Indonesia - One year on [accessed 20 May 2018].
[19] Indonesian Ministry of Health. Peraturan Menteri Kesehatan Republik Indonesia Nomor 38 Tahun 2016 Tentang Penyelenggaraan Transplantasi Organ [accessed 02 May 2018].
[20] American Urological Association. The State of the Urology Workforce and Practice in the United States 2016. [Accessed 05 May 2018].
[21] Palmer M, Taylor C . Workfor Predictions 2017 - British Association of Urological Surgeons. [Accessed 05 May 2018].
[22] Kucirka LM . Improving access to kidney transplantation: referral is not enough. J Am Med Assoc 2015; 314:565-7.
[23] Wang JH, Skeans MA, Israni AK . Current status of kidney transplant outcomes: dying to survive. Adv Chron Kidney Dis 2016; 23:281-6.
[24] Kuo T, Yip SK, Ng CF, Ng LG, Cheng CW . Outcome of laparoscopic live donor nephrectomy and impact of double renal arteries: results from two transplant centres. Asian J Surg 2010; 33:70-5.
No related articles found!
[1] . Testicular torsion in undescended testis: A persistent challenge[J]. Asian Journal of Urology, 0, (): 1 -5 .
[2] Antonio Benito Porcaro, Giovanni Novella, Matteo Balzarro, Guido Martignoni, Matteo Brunelli, Giovanni Cacciamani, Maria A. Cerruto, Walter Artibani. Prostate chronic inflammation type IV and prostate cancer risk in patients undergoing first biopsy set: Results of a large cohort study[J]. Asian Journal of Urology, 2015, 2(4): 224 -232 .
[3] . History and evolution of the use of oral mucosa for urethral reconstruction[J]. Asian Journal of Urology, 0, (): 1 -6 .
[4] Zhixiang Wang, Bing Liu, Xiaofeng Gao, Yi Bao, Yang Wang, Huamao Ye, Yinghao Sun, Linhui Wang. Laparoscopic ureterolysis with simultaneous ureteroscopy and percutaneous nephroscopy for treating complex ureteral obstruction after failed endoscopic intervention: A technical report[J]. Asian Journal of Urology, 2015, 2(4): 238 -243 .
[5] Louis R. Kavoussi. News from leading international academic urology departments[J]. Asian Journal of Urology, 2017, 4(1): 1 -2 .
[6] Rikiya Taoka, Yoshiyuki Kakehi. The influence of asymptomatic inflammatory prostatitis on the onset and progression of lower urinary tract symptoms in men with histologic benign prostatic hyperplasia[J]. Asian Journal of Urology, 2017, 4(3): 158 -163 .
[7] Cheuk Fan Shum, Weida Lau, Chang Peng Colin Teo. Medical therapy for clinical benign prostatic hyperplasia:a1 Antagonists, 5a reductase inhibitors and their combination[J]. Asian Journal of Urology, 2017, 4(3): 185 -190 .
[8] Sufyan Suleman, Gong-Hong We. Combined immunotherapy for advanced prostate cancer:Empowering the T cell army[J]. Asian Journal of Urology, 2017, 4(4): 199 -200 .
[9] Kok Kit Ng, Foo Cheong Ng. The use of antimuscarinics, phosphodiesterase type V inhibitors and phytotherapy for lower urinary tract symptoms in men[J]. Asian Journal of Urology, 2017, 4(3): 191 -194 .
[10] Jonathan Shunming Teo, Yee Mun Lee, Henry Sun Sien Ho. An update on transurethral surgery for benign prostatic obstruction[J]. Asian Journal of Urology, 2017, 4(3): 195 -198 .
Viewed
Full text


Abstract

Cited

  Shared   
  Discussed