Kidney transplant program at the Instituto Nacional de Cardiologia Ignacio Chavez]

The first renal transplant was done on July 22, 1968 and until December, 2010 a total of 865 procedures have been performed. Immunosuppressive protocols have changing with time: from 1968 to 1984 azathioprine + prednisone plus total radiation in some cases; from 1985 to 1998 cyclosporine + azathioprine + prednisone; in 1998 tacrolimus is used for first time; Mofetil micofenolate was available at 2005 and practically has displaced to azathioprine. As far as possible we use some induction therapy. Primary ESRD etiologies were: unknown (74.9%), glomerulonephritis (9.7%) and diabetic nephropathy (4.2%). Recipient's mean age was 29.9 +/- 11.6 years (12-70) and 35 +/- 9.8 years (18-62) in donors. Analysis group for graft and patient survival included 292 transplants (censured for death with functional graft) with a follow-up of 103 months (CI 95%: 99-108). Survival at 1, 5 and 10 years were: 95, 85 and 60% for graft as well as 100, 94 and 90% for patient. In year 2000 we started to perform renal biopsies at transplant (time zero biopsies), those results have been published and at present are a worldwide reference. In September, 2005 laparoscopic donor nephrectomy is initiated, 180 procedures have been done with excellent results. In year 2006, training in renal transplant acquires the endorsement as a Medicine Pos-grade recognized by the UNAM School of Medicine. We have participated in 9 national clinical trials and 6 international multicentric ones. Our renal transplant program offers a good choice for patients with low resources with similar results reported in the literature using current immunosuppressive schemes and surgical procedures. Institutional authorities and humanitarian associations support in addition to participation on investigation studies have been of vital importance.