Living-Related Kidney Graft Donors Sociodemographic Characteristics and Recipients Clinical Characteristics in Kenya: A Single Centre Experience Kenyatta National Hospital 2010-2015 Audit

Samuel Kabinga, Anthony Jude O. Were, Joshua K. Kayima, Seth O. McLigeyo, Patrick Mbugua, John Ngigi, Benjamin Wambugu, Nancy Wangombe

Abstract


This article provides summary of sociodemographic and clinical characteristics of the kidney transplant donors and recipients from 2010-2015 from Kenyatta national hospital, Nairobi, Kenya, East Africa. Only living-related organ donation is practiced in Kenya. Accelerated kidney transplantation activities picked up in Kenyatta national hospital from the 2010.

The duration from 2010-2015 has seen more kidney transplantations undertaken in the hospital than the ones done in the same hospital from 1984 when first transplantation was performed in Kenya to 2009. The data were extracted from manual medical records. There were about 120 kidney transplantations performed during this period but only 113 complete records were traceable.

There were 113 medical records for both kidney graft donors and recipients from 2010-2015. Demographic characteristics for donors and recipients captured included age, sex, and donor-recipient relationships. The mean donor age was 32.94±8.52 years, median age of 32years with minimum donor age of 20 years and maximum of 54 years. Fifty five percent (54.90%) of the donors were males. Among the recipients, the mean age was 39.15±12.68 years, median age of 36 years with the minimum recipient age of 14 years and maximum age of 66 years. Three in every four (74.30%) of recipients were males. First degree relatives contributed 85.60% of all the donors, with brothers and sisters to the recipients contributing almost equally (31.9% and 29.2%) respectively.  The recipients clinical characteristics include the primary disease, where hypertension and glomerular diseases contributed 85.0% while diabetes mellitus contributed 13.30% of the documented primary morbidity. Haemodialysis was the only modality of renal replacement therapy with a mean duration of 2.39±1.63 years and  modes of 2 and 3 years. The most popular vascular access for dialysis was permanent catheter (58.40%) with arteriovenous fistulae at 25.70%. Blood group O Rhesus positive was the commonest among donors and recipients (70.80% and 53.10% respectively). Blood transfusion was very common among the recipients before and around transplantation. (51% and 68% respectively). The HLA-A, -B, -DRB1 first and second loci match between the donors and recipients were zero match at 5.30%, one match at 9.70%, two matches at 11.50%, three matches at 38.10%, four matches at 20.40% five matches at 2.70% and six matches at 12.40%.  All the transplantations were first kidney transplants apart from one case.

In our living-related kidney transplantation programme, the donors are younger than recipients with males being transplanted more than females. First degree relatives dominate the donation. The commonest cause of the ESRD was glomerular diseases and hypertension. The program shows plausible feasibility of organ transplant where the most popular modality of renal replacement therapy.

 


Keywords


kidney donor; kidney graft recipient; renal registry; transplant registry.

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