1119 A Scoping Review of Kidney Transplantation in Africa: How Far Have We Come?

Abstract

Abstract Aim Kidney transplantation is a life-saving treatment for patients with end-stage kidney disease. However, the availability of kidney transplantation in Africa has lagged behind other regions of the world, leading to significant disparities in access to care. In this study, we sought to analyse indications for transplant, demographic characteristics, and outcomes of kidney transplantation in Africa from inception till date. Method The Preferred Reporting Items for Systematic Reviews and Meta-Analyses were used in conducting this study. PubMed, Google Scholar, and African Journal Online were searched. Data on procedure done, graft outcomes, donor, prophylaxis given for graft, post-op complications, and survival timelines were pooled together and analysed. Thirty-three studies fully satisfied the eligibility criteria and were used in this review. Results The most common causes of end-stage kidney disease requiring transplant included glomerulonephritis and Nephroangiosclerosis. Overall, open nephrectomy accounted for 95% of the surgical approach used. The other approaches documented were Hand-assisted Laparoscopic Nephrectomy (3.88%), Extraperitoneal approach (0.55%), and Simultaneous Unilateral native nephrectomy (0.12%). In total, 56.3% (4221) of all donors were living donors of which 68.5% were related to the recipient (living-related donor), while 43.7% (3280) patients received transplants from cadaveric donors. The commonest surgical complication was graft rejection (39.44%). In the follow-up period, 60.49% of patients who had a kidney transplant developed hypertension. Conclusions In conclusion, our study not only highlights the potential for kidney transplantation to improve the lives of patients in Africa, but also the need for further research and infrastructure development to make this a more widespread and successful option.