الفهرس | Only 14 pages are availabe for public view |
Abstract The goal when treating patient with end stage renal disease is to increase patient survival and to provide better quality of life and to date this could be achieved by kidney transplantation. Special problems associated with kidney transplantation were identified and documented and this is an essential step towards improved graft function and patient survival. Post transplanatation hip AVN is one of these problems which need special concern. The present work was designed to evaluate posttransplanatation hip AVN regarding; incidence, risk factors different modalities of treatment. This study comprise 40 patients who received their graft between march, 1976 and December, 2005 and developed hip AVN post transplantation. They were compared with healthy 80 kidney transplant recipients. from our study we conclude the following: 1- The incidence of posttransplant hip AVN among our recipients was 2.24%. 2- The most important risk factors for the development of posttransplantaion hip AVN were; a- Genetic predisposition specifically HLA A9, HLAB35 AND DR B15. b- Immunosuppressive drugs specially, corticosteroids and sirolimus c- Overweight with BMI more than 26 d- Hypercholesterolemia. _________________________________Summary & Conclusion______ ٩٠ 3- The appropriate treatment of early hip AVN is hip decompression while in advanced cases sooner or later hip replacement will be needed. 4-Hip AVN has no impact on graft and patient survival. Finally, we can recommend the following: 1- ESRD patients with genetic loci HLA A9, HLAB35 AND DR B15 and willing to have a renal allograft may be eligible to receive steroid and sirolimus free immunosuppressive regimen in order to avoid development of hip AVN. 2- Kidney transplant recipients should be advised to maintain ideal body weight and avoid obesity to save their hip joint from AVN. 3- Kidney transplant recipients should pay special attention to control lipid profile and hypercholesterolemia. |