The Course and Outcome of Renal Transplant Recipients Admitted to the Intensive Care Unit at a Tertiary Hospital in Saudi Arabia

Renal transplantation is the treatment of choice for most patients with end­stage renal disease (ESRD). This procedure provides a survival benefit compared to hemodialysis and is also cost effective. The aim of this study is to identify the types and incidence rates of complications that affect renal transplant recipients admitted to the intensive care unit (ICU) during long-term follow-up and, to examine the impact of these complications on the length of hospital stay as well as mortality, in a tertiary closed ICU in Saudi Arabia. We reviewed the data of all adult renal transplant recipients who were admitted to the ICU at the King Abdulaziz Medical City, Riyadh, between May 1999 and Oct 2006. During the study period, 80 patients had a total of 96 ICU admissions; 49% were females. The admission APACHE II score and expected mortality was 25+7 and 48+23 respectively. The hospital mortality rate was 42%. Sepsis was the major indication for ICU admission and pneumonia was the main cause of sepsis. In multivariate analysis the following variables were introduced in the model: APACHE II score, age, Glasgow Coma Score and need for hemodialysis in the ICU. We found only the need for hemodialysis during the ICU as an independent risk factor for mortality (P 0.02). We found in this study that the main reason for ICU admissions among renal transplant recipients was infections. Mortality rates for this particular population are relatively high and are primarily linked to need for dialysis.