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The aim of this study was to document vascular complications that occurred fol-lowing cadaveric and living donor kidney transplants in order to assess the overall incidence of these complications at our center as well as to identify possible risk factors. In a retrospective cohort study, 1500 consecutive renal transplant recipients who received a living or cadaveric donor kidney between December 1988 and July 2006 were evaluated. The study was performed at the Nemazee Hospital, Shiraz, Iran. The assessment of the anatomy and number of renal arteries as well as the incidence of vascular complications was made by color doppler ultrasonography, angiography, and/or surgical exploration. Clinically apparent vascular complications were seen in 8.86% of all study patients (n = 133) with the most frequent being hemorrhage (n = 91; 6.1%) followed by allo-graft renal artery stenosis (n = 26; 1.7%), renal artery thrombosis (n = 9; 0.6%), and renal vein thrombosis (n = 7; 0.5%). Vascular complications were more frequent in recipients of cadaveric organs than recipients of allografts from living donors (12.5% vs. 7.97%; P= 0.017). The occurrence of vascular complications was significantly more frequent among recipients of renal allografts with multiple arteries when compared with recipients of kidneys with single artery (12.3% vs. 8.2%; P= 0.033). The same was true to venous complications as well (25.4% vs. 8.2%; P< 0.001). Our study shows that vascular complications were more frequent in allografts with multiple renal blood vessels. Also, the complications were much less frequent in recipients of living donor transplants.

Data regarding the socioeconomic status in Iranian kidney transplant (KT) recipients is lacking. In this cross sectional descriptive study we evaluated the socio-economic status of 100 KT recipients in Shiraz organ transplantation center. In a cross-sectional design, we randomly selected and interviewed 100 RT recipients (50 males and 50 females). Data regarding age, gender, martial status, occupation, level of education, number of children, type of insurance, monthly household income, place of residence, ownership of a personal transportation device, duration and frequency of pre-transplant dialysis, family history of CRF (Chronic renal failure), and etiology of renal disease were obtained. There were 50 (50%) patients aged between 16 and 35 years, 55 had a family history of CRF, 60 had been on dialysis for more than a year, 61 were married, 47 did not have any children, 41 had more than 3 children, and 65 were unemployed due to physical and emotional impairment as a result of their disease. The majority (73%) did not have a high school diploma, 15% were illiterate, 85% were below the poverty line, 52% were from rural areas, and 98% were covered by insurance. We conclude that patients with CKD in our study had acquired this condition possibly due to negligence and lack of basic health care in the lower socioeconomic class. In addition, KT is an available therapeutic modality to lower socio-economic level in Iran.

It is well recognized that patients with end stage renal diseases (ESRD) have hyper-plastic parathyroid glands. In most patients, a decrease in parathyroid hormone (PTH) occurs by about 1 year after renal transplantation. However, some renal transplant recipients continue to have elevated level of PTH. We prospectively evaluated 121 patients undergoing renal transplantation between August 2000 and 2002. The duration of dialysis, calcium (Ca), phosphorus (P), albumin, creatinine and iPTH levels were recorded prior to transplantation and three months and one year after transplantation. These 121 patients were on dialysis for an average period of 17.4 months prior to transplantation. An increase in the serum Ca and a decrease in serum P and iPTH level was seen in the patients after transplantation (P< 0.001). Hyperparathyroidism was in 12 (9.9%) and 7 (5.7%) patients three months and one year after transplantation respectively. Elderly patients and patients with longer duration on dialysis had an increased risk of developing post transplant hyperpara-thyroidism and hypercalcemia in the first year post transplant (P< 0.05). In conclusion age and duration on dialysis before transplantation seems to be important risk factors for post transplant hyperparathyroidism.