Table 5.1.1: Stock and Flow of Renal Transplantation, Year New transplant patients Died Graft failure Lost to follow up Functioning graft at 31st December Figure 5.1.1: Stock and Flow of Renal Transplantation,

Table 5.1.2: New transplant rate per million population (pmp), Year New transplant patients New transplant rate, pmp Figure 5.1.2: New transplant rate, New Transplant rate, pmp Year Rate, pmp

Table 5.1.3: Transplant prevalence rate per million population (pmp), Year Functioning graft at 31st December Transplant prevalence rate, pmp Figure 5.1.3: Transplant prevalence rate, Transplant Prevalence rate, pmp Year Rate, pmp

Table 5.1.4: Place of transplantation, Year No.% % % % % % HKL UMMC Selayang Hospital Other local China India Other overseas Unknown TOTAL Year TOTAL No.% % % % % HKL UMMC Selayang Hospital Other local China India Other overseas Unknown TOTAL

Table 5.2.1: Renal Transplant Recipients’ Characteristics, Year New Transplant Patients Age at transplant (years), Mean Age at transplant (years), SD % Male % Diabetic (co-morbid / primary renal disease) % HBsAg positive % Anti-HCV positive

Table 5.2.2: Primary causes of end stage renal failure, Year No.% % % % % New transplant patients Glomerulonephritis Diabetes Mellitus Hypertension Obstructive uropathy ADPKD Drugs/toxic nephropathy Hereditary nephritis Unknown Others Year No.% % % % % New transplant patients Glomerulonephritis Diabetes Mellitus Hypertension Obstructive uropathy ADPKD Drugs/toxic nephropathy Hereditary nephritis Unknown Others

Table 5.3.1: Type of Renal Transplantation, Year No.% % % % % Commercial Cadaver Commercial Live Donor Live Donor (genetically related) Live Donor (emotionally related) Cadaver Total Year No.% % % % % Commercial Cadaver Commercial Live Donor Live Donor (genetically related) Live Donor (emotionally related) Cadaver Total *Commercial Cadaver (China, India, other oversea) *Commercial live donor (living unrelated) *Cadaver (local)

Table 5.3.2: Biochemical data, Biochemical parametersSummary Creatinine, umol/LN Mean SD Median 120 Minimum 3835 Maximum Hb, g/dLN Mean 12.9 SD 1.9 Median 12.9 Minimum Maximum Albumin, g/LN Mean 39.3 SD 10.5 Median 39.3 Minimum 2234 Maximum 5046 Calcium, mmol/LN Mean SD 0.2 Median 2.3 Minimum Maximum 3.3 Biochemical parametersSummary Phosphate, mmol/LN Mean1.1 SD0.2 Median1.1 Minimum0.3 Maximum Alkaline Phosphatase (ALP), U/L N Mean SD46.5 Median73 Minimum1018 Maximum Alanine Transferase (ALT), U/L N Mean SD Median 2524 Minimum 44 Maximum563613

Table 5.3.2: Biochemical data, Biochemical parametersSummary Total cholesterol, mmol/LN Mean SD 1.11 Median 5.4 Minimum Maximum LDL cholesterol, mmol/LN Mean 3.13 SD Median 3.1 Minimum 10.9 Maximum HDL cholesterol, mmol/LN Mean 1.6 SD Median 1.6 Minimum 0.2 Maximum Biochemical parametersSummary Systolic Blood Pressure, mmHg N Mean SD Median130 Minimum80 Maximum Diastolic Blood Pressure, mmHg N Mean SD Median80 Minimum4050 Maximum121127

Table 5.3.3: Medication data, Medication dataSingle drug treatmentCombined drug treatment N%N%N%N% All patients (i) Immunosuppressive drug(s) treatment Prednisolone Azathioprine Cyclosporin A Tacrolimus (FK506) Mycophenolate Mofetil (MMF) Rapamycin Others (ii) Non-Immunosuppressive drug(s) treatment Beta blocker Calcium channel blocker ACE inhibitor AIIRB Anti-lipid Other anti-hypertensive

Table 5.4.1: Post transplant complications, Post transplant complications Complication developed before transplant (regardless of complication after transplantation) Complication developed only after transplantation N%N%N%N% All patients Diabetes (either as Primary Renal Disease or co- morbid) Cancer Cardiovascular disease + cerebrovascular disorder Hypertension * Hypertension: BP systolic > 140 and BP diastolic >90 OR have either Beta blocker / Calcium channel blocker / ACE inhibitor / AIIRB / Other anti-hypertensive

Table 5.4.2: Transplant Patients Death Rate and Graft Loss, Year No. at risk Transplant death Transplant death rate % Graft loss Graft loss rate % Acute rejection Acute rejection rate % All losses All losses rate % *Graft loss=graft failure *All losses=death / graft loss (acute rejection happens concurrently with graft failure/ death)

Figure 5.4.2(i): Transplant Recipient Death Rate, Death rate percent Year Annual death rate

Figure 5.4.2(ii): Transplant Recipient Graft Loss Rate, Graft loss rate percent Year Annual graft loss rate

Table 5.4.3: Causes of Death in Transplant Recipients, Year No% % % % % % % % % % Cardiovascular Died at home Infection Graft failure Cancer Liver disease Accidental death Others Unknown TOTAL

Table 5.4.4: Causes of Graft Failure, Year No.% % % % % % % % % % Rejection Calcineurin toxicity Other drug toxicity Ureteric obstruction Infection Vascular causes Recurrent/de novo renal disease Others Unknown TOTAL

Table 5.4.5: Patient survival, Interval (years)No.% SurvivalSE * No.=Number at risk SE=standard error Figure 5.4.5: Patient survival,

Table 5.4.6: Graft survival, Interval (years)No.% survivalSE * No.=Number at risk SE=standard error Figure 5.4.6: Graft survival,

Table 5.4.7: Patient survival by type of transplant, Type of TransplantCommercial CadaverCommercial Live DonorLive DonorCadaver Interval (years)No.% SurvivalSENo.% SurvivalSENo.% SurvivalSENo.% SurvivalSE * No.=Number at risk SE=standard error

Figure 5.4.7: Patient survival by type of transplant, Cumulative survival Duration in years Commercial cadaver Commercial live donor Live donor Cadaver

Table 5.4.8: Graft survival by type of transplant, Type of TransplantCommercial CadaverCommercial Live DonorLive DonorCadaver Interval (years)No.% SurvivalSENo.% SurvivalSENo.% SurvivalSENo.% SurvivalSE * No.=Number at risk SE=standard error

Figure 5.4.8: Graft survival by type of transplant, Cumulative survival Duration in years Commercial cadaver Commercial live donor Live donor Cadaver

Table 5.4.9: Patient survival by year of transplant (Living related transplant, ) Year of Transplant Interval (years)No.% SurvivalSENo.% SurvivalSE * No.=Number at risk SE=standard error

Figure 5.4.9: Patient survival by year of transplant (Living related transplant, ) Cumulative survival Duration in years Year Year

Table : Graft survival by year of transplant (Living related transplant, ) Year of Transplant Interval (years)No.% SurvivalSENo.% SurvivalSE * No.=Number at risk SE=standard error Figure : Graft survival by year of transplant (Living related transplant, ) Cumulative survival Duration in years Year Year

Table : Patient survival by year of transplant (Commercial cadaver transplant, ) Year of Transplant Interval (years)No.% SurvivalSENo.% SurvivalSE * No.=Number at risk SE=standard error Figure : Patient survival by year of transplant (Commercial cadaver transplant, ) Cumulative survival Duration in years Year Year

Table : Graft survival by year of transplant (Commercial cadaver transplant, ) Year of Transplant Interval (years)No.% SurvivalSENo.% SurvivalSE * No.=Number at risk SE=standard error Figure : Graft survival by year of transplant (Commercial cadaver transplant, ) Cumulative survival Duration in years Year Year

Table 5.5.1: Risk factors for IHD in renal transplant recipients at year 2004 and Diabetes 28 (1.9)19 (1.2) Hypertension** 504 (34.3)513 (33.5) CKD 121 (8.2)142 (9.3) Diabetes + Hypertension**145 (9.9)157 (10.3) Diabetes + CKD21 (1.4)20 (1.3) CKD + Hypertension**530 (36.1)538 (35.2) Diabetes + CKD + Hypertension**120 (8.2)141 (9.2) ** Hypertension: BP systolic > 140 and BP diastolic >90 OR have either Beta blocker / Calcium channel blocker/ ACE inhibitor/ AIIRB / Other anti-hypertensive drugs GFR(mL/min/1.73m 2 ) = 1.2*(140-age(year))* weight(kg) / creatinine(µmol/L) if male GFR(mL/min/1.73m 2 ) = 0.85*(1.2*(140-age(year))* weight(kg) / creatinine(µmol/L) ) if female. CKD stage III – GFR, CKD stage IV – GFR, CKD stage V – GFR, < 15

Figure 5.5.1a: Venn Diagram for Pre and Post Transplant Complications (in %) at year Hypertension Diabetes

Figure 5.5.1b: Venn Diagram for Pre and Post Transplant Complications (in %) at year DiabetesHypertension

Table 5.5.2a: Systolic BP, 2004 – No. (%) Systolic BP < (13.4)232 (14.2) Systolic BP < (22.0)318 (19.5) Systolic BP (29.6)474 (29.0) Systolic BP (27.0)452 (27.7) Systolic BP (6.6)133 (8.1) Systolic BP >=18023 (1.5)24 (1.5)

Figure 5.5.2a: Systolic BP, 2004 and 2005 Percent Year Systolic BP <120 Systolic BP <130 Systolic BP Systolic BP Systolic BP Systolic BP >=

Table 5.5.2b: Diastolic BP, 2004 and No. (%) Diastolic BP<80454 (29.3)465 (28.5) Diastolic BP<85661 (42.6)712 (43.6) Diastolic BP (3.1)73 (4.5) Diastolic BP (20.6)308 (18.9) Diastolic BP (3.6)65 (4.0) Diastolic BP >=11012 (0.8)10 (0.6)

Figure 5.5.2b: Diastolic BP, 2004 and 2005 Percent Year Diastolic BP <80 Diastolic BP <85 Diastolic BP Diastolic BP Diastolic BP Diastolic BP >=

Table 5.5.3: CKD stages, No. (%) CKD stage 1121 (7.9)118 (7.3) CKD stage 2570 (37.0)578 (35.6) CKD stage 3726 (47.1)798 (49.1) CKD stage 4110 (7.1)112 (6.9) CKD stage 513 (0.8)19 (1.2)

Figure 5.5.3: CKD stages by year Percent Year CKD Stage 1 CKD Stage 2 CKD Stage 3 CKD Stage 4 CKD Stage

Table 5.5.4: BMI, 2004 – No. (%) BMI <20242 (15.6)253 (15.5) BMI (39.4)656 (40.2) BMI (32.2)512 (31.4) BMI > (12.8)212 (13.0) Figure 5.5.4: BMI by year Percent Year BMI <20 BMI BMI BMI >

Table 5.5.5a: LDL, 2004 – No. (%) LDL < (18.2)418 (25.6) LDL (60.9)860 (52.7) LDL >= (20.9)355 (21.7) Figure 5.5.5a: LDL by year Percent Year LDL <2.6 LDL LDL >=

Table 5.5.5b: Total Cholesterol, No. (%) Total Cholesterol < (7.3)159 (9.7) Total Cholesterol (26.6)455 (27.9) Total Cholesterol (48.5)772 (47.3) Total Cholesterol (12.7)173 (10.6) Total Cholesterol > (4.9)74 (4.5) Figure 5.5.5b: Total Cholesterol by year Percent Year Total Cholesterol <4.1 Total Cholesterol Total Cholesterol Total Cholesterol Total Cholesterol >

Table 5.5.5c: HDL, No. (%) HDL <187 (5.6)118 (7.2) HDL (16.5)308 (18.9) HDL > (77.9)1207 (73.9) Figure 5.5.5c: HDL by year Percent Year HDL <1 HDL, HDL >

Table 5.5.6a: Treatment for hypertension, 2004 – 2005 YearNo.% on anti-hypertensives% on 1 anti-hypertensive drug% on 2 anti-hypertensives% on 3 anti-hypertensives Table 5.5.6b: Distribution of Systolic BP without anti-hypertensives, 2004 – 2005 YearNo.MeanSDMedianLQUQ % Patients >= 160 mmHg Table 5.5.6c: Distribution of Diastolic BP without anti-hypertensives, 2004 – 2005 YearNo.MeanSDMedianLQUQ % Patients >= 90 mmHg

Table 5.5.6d: Distribution of Systolic BP on anti-hypertensives, 2004 – 2005 YearNo.MeanSDMedianLQUQ % Patients >= 160 mmHg Table 5.5.6e: Distribution of Diastolic BP on anti-hypertensives, 2004 – 2005 YearNo.MeanSDMedianLQUQ % Patients >= 90 mmHg