Horizons in TransplantationKidney transplantationEpidemiological Characteristics of the Largest Kidney Transplant Program in Mexico: Western National Medical Center, Mexican Institute of Social Security

•We describe characteristics of and compare changes over time for the largest kidney transplantation program in Mexico.•We collected data on 3643 kidney transplants, the majority (3236) involving living donors.•Recipients in our program are relatively young persons with unknown etiology of end-stage renal disease.•During the program evolution, the age of our recipients has diminished and the age of donors has increased.•We observed a graft and a patient survival rate of 95.9% and 97%, respectively.

BackgroundAccording to the National Transplant Center (CENATRA), in 2013, a total of 2707 transplantations were performed in Mexico; of them, 10% (270 transplantations) were done in our Tertiary Care Hospital (Western National Medical Center). This means that one in 10 transplant recipients undergoes transplantation at our medical center. The aim of our study was to describe the characteristics of and to compare changes in the kidney transplantation program over time.Materials and MethodsThis was a cross-sectional study. Data were collected from the hospital transplant registry from January 1994 to December 2014.ResultsDuring the study period, 3643 kidney transplantations were conducted; most were living donor 3236 (89%), and only 407 patients (11%) received a graft from a deceased donor. Of living donors, 2786 (87%) were related, and 450 (13%) were genetically unrelated. The average recipient age was 28 years, and the average age of the donor was 34 years. It was observed that siblings donated more frequently (51%), followed by parents (34%). Among unrelated donors, spouses donated the most (66%). In 80% of cases, the cause of end-stage renal disease (ESRD) was unknown (80%). The most frequent renal replacement therapy was peritoneal dialysis (54%), followed by hemodialysis (18%); only 5% of patients received preemptive kidney transplant. The most frequent immunosuppression scheme was tacrolimus, mycophenolate mofetil, and prednisone in 70% of patients.ConclusionThe Western National Medical Center is the largest kidney transplantation program in Mexico. The main activity is living donor transplantation. Recipients are relatively young persons with unknown etiology of ESRD.