Patient and Graft Survival Rates at Five Years Following Kidney Transplant at the National Transplantation Center in Ethiopia

Abstract

Abstract Background: Kidney transplantation is the preferred mode of renal replacement therapy once ESKD occurs. It improves survival and quality of life at reduced overall cost compared to dialysis. In Ethiopia living donor kidney transplantation was started in September 2015 and 1- year survival is found to be excellent. Long term survival, however, remains unknown. Objective: to determine five-year graft and patient survival and their predictors among the cohort of recipients operated in the National Kidney transplantation center from September 1 2015 to November 15 2018. Methods and Materials: A retrospective review of the cohort was conducted. Baseline sociodemographic, clinical, donor characteristics, peri-operative and post-operative follow up data were collected from the medical records of kidney transplant recipients and their donors using a structured printed tool. The collected data were and analyzed using IBM SPSS statistics version 29. Five-year graft and patient survival rates were determined. Predictors of five year patient and graft survival were identified using logistic regression. Results: Ninety two recipients were included. Mean + SD was 34.07 + 11.26 years. Sixty-four (68.8%) were male. Cause of ESKD was unknown for 59 (64.1%). Mean + SD age of donors was 34.9 + 11.9 years. All except 9 (9.8%) were related to the recipient. Five year patient survival was 83.7% . Age > 40 years, being married, longer duration of post-op admission, record of serious infection during post-transplantation follow -up, record of graft rejection and biopsy predicted significantly reduced reduced five year patient survival. Tertiary education predicted significantly better five year patient survival. Five year death censored graft survival was 90%. Donor 24 hour urinary protein level, record of graft rejection and number of hospital admissions predicted reduced five-year death censored graft survival. Conclusions: Five year survival rate of recipients at the National Transplantation Center of Ethiopia is acceptible and encouraging. The death censored graft survival rate five years is comparable to those in developed regions. Recommendations: Efforts to improve and sustain the kidney trasplantation services are recommended. Further studies on long term outcomes and causes of death are also recommended. Keywords: kidney transplantation, five-year survival, predictor, Ethiopia