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Objectives: To compare patient graft survival between various subgroups among renal transplant patients., Patients and Methods: A retrospective analysis of all renal transplant patients from January 1, 1993, to June 1, 2003, was performed using follow-up records and data submitted to the National Renal Registry., Results: A total of 91 renal transplant patients were followed, with a male-to-female ratio of 57:34 (62.6%:37.4%) and mean age at transplant 35.6 +/- 12.1 years (range 10.1-64.4 years) with 38 (41.8%) cases transplanted locally and 53 (58.2%) cases transplanted overseas, of which 36 (39.6%) were from live donors and the remaining 55 (60.4%) from cadavers. As of June 1, 2003, 50 transplant patients are on regular follow-up, with 41 patients lost due to 12 (29.3%) deaths, 16 (39.0%) graft failures, 11 (26.8%) transfers, and 2 (4.9%) lost to follow-up. Overall patient and graft survival rates at 2, 5, and 10 years were 93.1%, 77.4%, and 49.2%, respectively. Survival rates for male transplant patients were 91.4%, 71.9%, and 46.7% compared to 96.1%, 86.9%, and 53.6% for females. Survival rates for Malay race patients were 92.0%, 59.5%, and 28.6%; Chinese rates were 96.0%, 81.6%, and 54.8%, and Indian rates were 81.0%, 81.0%, and 46.3%, respectively. The survivals for transplants from living donors were 96.9%, 85.6%, and 62.3% compared to cadaveric kidney transplants namely 89.9%, 71.3%, and 35.0%. The local transplant survival rates were 96.9%, 82.3%, and 60.8% compared to overseas transplants, with survival rates of 89.9%, 73.5%, and 35.7%. Finally, living-related donor transplantation survival rates were 96.8%, 84.9%, and 62.2% compared to nonrelated donors-90.1%, 71.3%, and 35.0%-at 2 years, 5 years, and 10 years, respectively., Conclusion: Overall survival has been good. The survival rates were better among female gender, Chinese race, local transplantation, and kidneys from living-related donors.

We report here a case of a kidney transplant recipient in whom the ureter was initially implanted into the peritoneum. Excessive ultrafiltration volume and reversal of serum vs dialysate creatinine ratio when the patient was recommenced on continuous ambulatory peritoneal dialysis first suggested the diagnosis which was subsequently confirmed by a plain abdominal x-ray demonstrating placement of ureteric stent in the peritoneum. This rare complication was successfully corrected with surgical re-implantation of ureter into the bladder and 5 years later, the patient remains well with good graft function.

There were 72 pregnancies in 46 renal transplants (RTs) between 1984 and 2001, 89% from living donors, 11% cadaveric. Mean age at RT was 26.9 +/- 4.3 years and at pregnancy 30.7 +/- 4.7 years. Mean time to pregnancy after RT was 4.5 +/- 3.1 years. 54% were unplanned. 45 (63%) resulted in surviving infants, 37% delivered by Caesarean section. 35% were premature. Mean birth weight was 2.38 +/- 0.57 kg. 64% were on cyclosporine. No patient had an acute rejection during pregnancy; 38% had pre-existing hypertension. Complications include urinary infection (13%), proteinuria (15%) and preeclampsia (15%). Mean serum creatinine before pregnancy was 112.7 +/- 32.6 umol/l, 1 year post-pregnancy it was 119.4 +/- 38.7. The mean time of follow up of mothers is 4.9 +/- 3.5 years. 10 year graft survival was 83% and patient survival 94%.