With increasing long-term graft survival and life-long immunosuppression,
cardiovascular disease and infectious complications are major causes of morbidity and mortality. We undertook the present study to compare clinical and biochemical risk factors, graft complications, and rejection episodes of alive kidney recipients with dead ones among 1200 kidney transplant patients. We retrospectively evaluated 1200 kidney transplant patients who were consecutively operated from December 1988 to December 2003 in Shiraz Organ Transplant Center. Data regarding age and sex of donors, and recipients, source of donated kidney (livingrelated, -unrelated, or cadaveric), serum hematological and biochemical profile (LDL, HDL, Cholesterol, TG, Hemoglobin, Urea, and Creatinine levels), Blood Pressure, rejection episodes, and cause of death were collected to compare alive and dead recipients. One hundred fifty six patients (13%) died in the post transplant period. Patient death has been more prominent in first years of the study. Most common causes of death were cardiovascular (28.3%), graft loss (20.7%), and infections (19.6%). Post transplant systolic and diastolic blood pressures, BUN, Creatinine, fasting blood sugar, and total cholesterol were higher, and serum HDL was lower in dead recipients (P<0.05). No significant difference was found in LDL, Hemoglobin, and triglyceride values between two groups. The 1- and 3-year patient survival rates were 94% and 91.5%, respectively. It is reasonable to adopt a broad-based approach aimed at reducing LDL, cholesterol, mean blood pressure, and other major risk factors for cardiovascular disease with individual tailoring of immunosuppressive therapy to reduce chronic allograft nephropathy and cardiovascular disease in this patient population. Infections can be reduced with early diagnosis, use of proper antibiotics, better post Op care, and avoidance of excessive and unnecessary immunosuppression.