Experience and Early outcomes of Kidney Transplantation in a Nigerian Transplant Institution.

Abstract

Introduction: With the rise in population of patients with End-stage Renal Disease (ESRD) in Nigeria, there is an increased demand for Renal Replacement Therapy (RRT) including kidney transplantation (KT). We present our surgical experience with KT in Zenith Medical and Kidney Center Abuja, Nigeria. Methods: A 9-month retrospective review of patients who underwent KTbetween January and September 2019 in our center. Data of both kidney donors and recipients were recorded in designed proforma. Extracted information includes demographic characteristics, side of open donor nephrectomy (ODN), recipient anatomy, surgical techniques and post-operative outcomes. Data was analyzed using SPSS version 21. Results: A total of 68 patients had KT during the period under review. Donors had an age range of 19 to 53 years with mean of 30.83±8.43years while recipients aged between 10 and 73years with mean of 45.97±13.71 years. There were 61 (89.7%) male and 7 (10.3%) female donors. Forty-nine of the recipients were males (72.1%) and 19 (27.9%) were females. Left ODN was performed in 75% of cases and the commonest indication for right ODN was multiple left renal arteries. The allograft was placed in the right iliac fossa in all the patients with the external iliac vessels preferred for anastomosis in end-to-side fashion. Ureteroneo- cystostomy using the Lich-Gregoir technique over a double-J stent was performed in all patients. Significant peri-operative haemorrhage necessitating blood transfusion were experienced in 3 (4.4%) patients. Renal allograft artery thrombosis leading to allograft nephrectomy was encountered (1,1.4%). There was no peri-operative mortality. Conclusion: Kidney transplantation can be safely and routinely carried out in Nigeria. There is need for more Nigerian urologists and institutions interested in KT in order to cater for the teeming population of ESRD patients in the country.