Browsing by Author "Mostafa, Amani"

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End-stage Renal Disease Among Living-Kidney Donors: Single-center Experience
(Başkent Üniversitesi, 2011-02) Wafa, Ehab W.; Ghoneim, Mohamed A.; Ghar, Mohamed I. Abo El; Mostafa, Amani; Sheashaa, Hussein A.; Fouda, Mohamed A.; Abbas, Tarek M.; Refaie, Ayman F.
Objectives: Renal transplant from living donors is widely accepted as a highly effective treatment for end-stage renal disease. Donors undergo a major operation with considerable perioperative risks of morbidity and mortality. Living with a single kidney also confers long-term risks. This study sought the incidence and causes of end-stage renal disease among living kidney donors. Materials and Methods: This study included all donors who had reached end-stage renal disease among 2000 consecutive living-kidney donors. All operations and follow-up were performed in a single center. We studied the onset of renal disease, cause of end-stage renal disease, date of replacement therapy, and outcome. We also revised the donor’s medical records related to their corresponding recipients. Results: Of 2000 living donors, 8 developed end-stage renal disease; 6 were men (mean age, 30.87 ± 5.84 years. Renal failure occurred 5 to 27 years after donation. Renal transplant was done in 1 donor. Medical complications were proteinuria (6 patients), hypertension (7 patients), diabetes (3 patients), gout (3 patients), ischemic heart disease (5 patients), and hepatitis viral infection (4 patients). The causes of end-stage renal disease were diabetic nephropathy in 3 patients. Other possible causes included toxic nephropathy, chronic pyelonephritis, and preeclampsia. Conclusions: Living kidney donation is safe, and development of renal failure after donation is caused by the same causes as in the general population.
Nomogram That Predicts Graft Survival Probability Following Living-Donor Kidney Transplant
(Başkent Üniversitesi, 2008-03) Akl, Ahmed; Ghoneim, Mohamed A.; Mostafa, Amani
Objectives: The goal of this project was to develop a nomogram that predicts the probability of graft survival at 5 years. Materials and Methods: From our dataset, 1581 patients were used to construct a nomogram (modeling group), the remaining 319 patients (testing group) were used for its validation. Initially, the modeling group variables were correlated with graft survival by univariate analysis. Significant factors were subjected to a multivariate analysis using a Cox regression model. The results formed the basis of our nomogram construction. Internal validation was done first by discrimination using the concordance index. Second, the calibration was assessed graphically. And finally, for external validation, the nomogram was used to predict graft survival using the testing group. The predicted probability(s) was compared with the actual survival estimates. Results: Validation of the nomogram yielded a concordance index of 0.77, and the observed correspondence between predicted and actual outcomes suggested a high level of calibration. Nomogram predictions of the testing group revealed no differences in the means of predicted and observed graft survival at 5 years, with a high correlation coefficient and accepted predictive accuracy (concordance index, 0.72). Conclusions: We developed a well-validated and reasonably precise nomogram for predicting 5-year graft survival.