Clinical profile and outcome of kidney transplantation at Muhimbili National Hospital, Tanzania.
Chronic kidney disease
Kidney transplantation
Muhimbili National Hospital
Journal
BMC nephrology
ISSN: 1471-2369
Titre abrégé: BMC Nephrol
Pays: England
ID NLM: 100967793
Informations de publication
Date de publication:
28 Sep 2024
28 Sep 2024
Historique:
received:
27
07
2024
accepted:
19
09
2024
medline:
29
9
2024
pubmed:
29
9
2024
entrez:
28
9
2024
Statut:
epublish
Résumé
Kidney transplantation is the definitive treatment option for chronic kidney failure, offering improved quality of life and extended survival. Access to kidney transplantation is limited in the Sub-Saharan Africa (SSA) region, with only a few countries with established services. Tanzania started its program five years ago, for the sustainability of the program it is important to understand the outcome. Therefore, this study was conducted to determine the clinical outcomes and survival rates of kidney transplant recipients at Muhimbili National Hospital in Tanzania, in the absence of a national transplant registry, since the inception of the program. This was a retrospective study conducted among kidney transplant recipients from live donors at Muhimbili National Hospital (MNH) between November 2017 and February 2022. Analyses were performed to assess baseline characteristics, post-transplant complications, and patient and graft survival. In our study of 68 kidney transplant recipients, the majority of recipients were male (63.2%) with a mean age of 45.8 years and under medical insurance (88.2%). The predominant cause of CKD was hypertension (58.2%) with recipients undergoing dialysis for a mean duration of 14.4 months, and basiliximab being the most commonly used induction medication (57.3%). The majority of donors were males (64.7%) and had first-degree relationships with recipients (76.5%). Haploid HLA mismatch was observed in 36.8% of cases. One-year patient and graft survival rates were 91.2% and 96.7%, respectively, with infection being the primary cause of death (n = 5), and more than half of deceased patients died with a functioning graft (n = 4). Our study underscores favorable one-year patient and graft outcomes among kidney transplant recipients at Muhimbili National Hospital, Tanzania. However, challenges persist, notably with infections posing ongoing difficulties for this cohort.
Sections du résumé
BACKGROUND
BACKGROUND
Kidney transplantation is the definitive treatment option for chronic kidney failure, offering improved quality of life and extended survival. Access to kidney transplantation is limited in the Sub-Saharan Africa (SSA) region, with only a few countries with established services. Tanzania started its program five years ago, for the sustainability of the program it is important to understand the outcome. Therefore, this study was conducted to determine the clinical outcomes and survival rates of kidney transplant recipients at Muhimbili National Hospital in Tanzania, in the absence of a national transplant registry, since the inception of the program.
METHODS
METHODS
This was a retrospective study conducted among kidney transplant recipients from live donors at Muhimbili National Hospital (MNH) between November 2017 and February 2022. Analyses were performed to assess baseline characteristics, post-transplant complications, and patient and graft survival.
RESULTS
RESULTS
In our study of 68 kidney transplant recipients, the majority of recipients were male (63.2%) with a mean age of 45.8 years and under medical insurance (88.2%). The predominant cause of CKD was hypertension (58.2%) with recipients undergoing dialysis for a mean duration of 14.4 months, and basiliximab being the most commonly used induction medication (57.3%). The majority of donors were males (64.7%) and had first-degree relationships with recipients (76.5%). Haploid HLA mismatch was observed in 36.8% of cases. One-year patient and graft survival rates were 91.2% and 96.7%, respectively, with infection being the primary cause of death (n = 5), and more than half of deceased patients died with a functioning graft (n = 4).
CONCLUSION
CONCLUSIONS
Our study underscores favorable one-year patient and graft outcomes among kidney transplant recipients at Muhimbili National Hospital, Tanzania. However, challenges persist, notably with infections posing ongoing difficulties for this cohort.
Identifiants
pubmed: 39342167
doi: 10.1186/s12882-024-03765-x
pii: 10.1186/s12882-024-03765-x
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
323Informations de copyright
© 2024. The Author(s).
Références
Stanifer JW, Maro V, Egger J, Karia F, Thielman N, Turner EL, et al. The epidemiology of chronic kidney disease in Northern Tanzania: a population-based survey. PLoS ONE. 2015;10(4):1–12.
doi: 10.1371/journal.pone.0124506
Ploth DW, Mbwambo JK, Fonner VA, Horowitz B, Zager P, Schrader R et al. Prevalence of CKD, diabetes, and hypertension in Rural Tanzania. Kidney Int Rep. 2018;3(4):905–15. https://doi.org/10.1016/j.ekir.2018.04.006
Mwemezi O, Ruggajo P, Mngumi J, Furia FF. Renal dysfunction among HIV-infected patients on antiretroviral therapy in Dar es Salaam, Tanzania: a cross-sectional study. Int J Nephrol. 2020;2020.
Bamgboye EL. Kidney transplantation in Sub-Saharan Africa: history and current status. Kidney360. 2023;4(12):1772–5.
doi: 10.34067/KID.0000000000000293
pubmed: 37962555
pmcid: 10758520
Furia FF, Shoo J, Ruggajo PJ, Kilonzo K, Basu G, Yeates K et al. Developing nephrology services in low income countries: a case of Tanzania. BMC Nephrol. 2019;20(1).
Boenink R, Kramer A, Tuinhout RE, Savoye E, Åsberg A, Idrizi A, et al. Trends in kidney transplantation rate across Europe: a study from the ERA registry. Nephrol Dialysis Transplantation. 2023;38(6):1528–39.
doi: 10.1093/ndt/gfac333
Garcia-Garcia G, Harden P, Chapman J. The global role of kidney transplantation. Indian J Nephrol. 2012;22(2):77–82.
doi: 10.4103/0971-4065.97101
pubmed: 22787305
pmcid: 3391826
Matsha TE, Erasmus RT. Chronic kidney disease in sub-Saharan Africa. Lancet Glob Health. 2019;7(12):e1587–8. https://doi.org/10.1016/S2214-109X(19)30467-X
Furia FF, Shoo JG, Ruggajo PJ, Mngumi JW, Valentine G, Muhiddin MA et al. Establishing kidney transplantation in a low-income country: a case in Tanzania. Ren Replace Ther. 2024;10(1).
Rosa-Diez G, González-Bedat MC, Luxardo R, Ceretta ML, Ferreiro-Fuentes A. Step-by-step guide to setting up a kidney replacement therapy registry: the challenge of a national kidney replacement therapy registry. Clin Kidney J. 2021;14(7):1731–7.
doi: 10.1093/ckj/sfab015
pubmed: 34221380
pmcid: 8243280
Davids MR, Caskey FJ, Young T, Balbir Singh GK. Strengthening renal registries and ESRD research in Africa. Semin Nephrol. 2017;37(3):211–23. https://doi.org/10.1016/j.semnephrol.2017.02.002
Ghelichi-Ghojogh M, Ghaem H, Mohammadizadeh F, Vali M, Ahmed F, Hassanipour S et al. Graft and patient survival rates in kidney transplantation, and their associated factors: a systematic review and meta-analysis. Vol. 50, Iran J Public Health. 2021. https://creativecommons.org/licenses/by-nc/4.0/
Poggio ED, Augustine JJ, Arrigain S, Brennan DC, Schold JD. Long-term kidney transplant graft survival—making progress when most needed. Am J Transplant. 2021;21(8):2824–32.
doi: 10.1111/ajt.16463
pubmed: 33346917
Rezapour S, Yarmohammadi A, Tavakkoli M. One-year survival rate of renal transplant: factors influencing the outcome. Transpl Res Risk Manage. 2017;9:49–56.
Ghelichi-Ghojogh M, Mohammadizadeh F, Jafari F, Vali M, Jahanian S, Mohammadi M et al. The global survival rate of graft and patient in kidney transplantation of children: a systematic review and meta-analysis. BMC Pediatr. 2022;22(1).
Arogundade FA. Kidney transplantation in a low-resource setting: Nigeria experience. Kidney Int Suppl (2011). 2013;3(2):241–5.
doi: 10.1038/kisup.2013.23
pubmed: 25018990
Beerli N, Denhaerynck K, Binet I, Dahdal S, Dickenmann M, Golshayan D et al. Age at time of kidney transplantation as a predictor for mortality, graft loss and self-rated health status: results from the Swiss transplant cohort study. Transpl Int. 2022;35.
Shi X, Lv J, Han W, Zhong X, Xie X, Su B et al. What is the impact of human leukocyte antigen mismatching on graft survival and mortality in renal transplantation? A meta-analysis of 23 cohort studies involving 486,608 recipients. BMC Nephrol. 2018;19(1).
Manski CF, Tambur AR, Gmeiner M. Predicting kidney transplant outcomes with partial knowledge of HLA mismatch. Proc Natl Acad Sci U S A. 2019;116(41):20339–45.
doi: 10.1073/pnas.1911281116
pubmed: 31548419
pmcid: 6789916
Minkovich M, Gupta N, Liu M, Famure O, Li Y, Selzner M et al. Impact of early surgical complications on kidney transplant outcomes. BMC Surg. 2024;24(1).
Lempinen M, Stenman J, Kyllönen L, Salmela K. Surgical complications following 1670 consecutive adult renal transplantations: a single center study. Scand J Surg. 2015;104(4):254–9.
doi: 10.1177/1457496914565419
pubmed: 25567856
Persy VP. Prevention and transplantation in chronic kidney disease: what is achievable in emerging countries? Meeting report: Bamako meeting December 4–6, 2008. Nephron Clin Pract. 2010;115(2):c122-32. https://doi.org/10.1159/000312875 . Epub 2010 Apr 22. PMID: 20413991. Nephron Clin Pract. 2010;155(2):122–32.