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"ABSTRACTBACKGROUND:kidney transplantation has been developing rapidly in Indonesia in recent years, yet data on transplants' characteristics and survival is still unavailable. In Indonesia, only living donors are permitted. Living donor are advantageous, but challenging to recruit. This study aimed to establish the graft and patient survival rates and to describe the characteristics of recipient and donor as well as the process of donor recruitment and evaluation of kidney transplantation in Indonesia.METHODS:the study was a retrospective cohort on all donors and kidney transplant recipients at Cipto Mangunkusumo General Hospital (CMGH) from January 2011 to May 2017. Only recipients from January 2011 to May 2014 were included to establish the 1-year and 3-year graft and patient survival; which were described using Kaplan-Meier method. RESULTS:data from 492 kidney transplant procedures were obtained (donor median age, 30 (17 - 66) years; 25.1% were family-related. Recipients mean age, 47 (SD 13.18 years). Data from total of 138 kidney transplant recipients were further analyzed. The 1-year death- censored graft survival, all-cause graft survival and patient survival were 92 %, 82.6 % and 87%. The 3-year death-censored graft survival, all-cause graft survival and patient survival were 90.6%, 76.1% and 79.7%. Kaplan-Meier's curve showed the highest mortality rates occured in the early months.CONCLUSION:the 1-year graft and patient survival rate were 92% and 87%. The 3-year graft and patient survival rate were 90.6% and 79.7%. Only small percentage of donor were family-related. Living donor recruitment and evaluation are still a big challenge in Indonesia"

"Background: living kidney donation is a safe medical procedure. Kidney function after donation is crucial for donors’ health and quality of life. Kidney hyperfiltration is a compensatory mechanism, which will preserve kidney function after unilateral nephrectomy. The number of studies regarding hyperfiltration in living kidney donors is limited. Our study aimed to explain kidney hyperfiltration mechanism and evaluate its effect on the kidney function within 30 days after surgery. Methods: our study was a prospective cohort study with 46 living-kidney donors participating in the study between April and December 2019. We evaluated main outcomes, the 30-day post-surgery kidney function, which was evaluated by calculating estimated glomerular filtration rate (eGFR) and Urinary Albumin to Creatinine Ratio (ACR). The subjects were categorized into two groups based on their 30-day outcomes, which were the adaptive (eGFR > 60 mL/min/1.73 m2 and/or ACR > 30 mg/g) and maladaptive (eGFR < 60 mL/min/1.73 m2 and/or ACR > 30 mg/g) groups. A series of evaluation including calculating the renal arterial resistive index (RI) and measuring urinary vascular endothelial growth factor (VEGF), neutrophil gelatinase-associated lipocalin (NGAL), and heparan sulfate (HS) levels were performed before surgery and serially until 30 days after surgery. Multivariate analysis with adjustments for confounding factors was done. Results: forty donors were included and mostly were female (67.5%). The average age and body mass index (BMI) were 45.85 (SD 9.74) years old and 24.36 (SD 3.73) kg/m2 , respectively. Nineteen donors (47.5%) had maladaptive hyperfiltration outcomes. The hyperfiltration process was demonstrated by significant changes in renal arterial RI, urinary VEGF, NGAL, and HS levels (p<0.005). There was no significant difference regarding RI, urinary VEGF, NGAL, and HS levels between both groups. Several confounding factors (BMI over 25 kg/m2 , familial relationship, age over 40 years old, and arterial stiffness) were significantly influenced by kidney hyperfiltration and outcomes (p<0.05). Conclusion: the hyperfiltration process does not affect the 30-day post-nephrectomy kidney function of the donors. Several other factors may influence the hyperfiltration process and kidney function. Further study is necessary to evaluate kidney function and its other related variables with a longer period of time study duration."