Abstract
BackgroundKidney transplantation is the renal replacement therapy of choice for end stage renal disease. To ensure safety regular audit of the donation process is necessary. The aim of this study was to assess the evaluation of potential living related kidney donors and document their outcomes following nephrectomy.MethodsThis was a retrospective descriptive study involving all living related kidney donors seen at Kenyatta National Hospital (KNH) renal unit from 2010 to 2014.Upon approval by KNH/ERC, the records of all kidney donors were retrieved. Demographic characteristics, number of potential and actual donors, their clinical, laboratory and radiological data as well as documented complications and deaths were recorded. SPSS version 17(Chicago, Ilinois) was used for data entry and analysis. Chi square test and Mann Whitney U test were used as tests of association for categorical and continuous data respectively, with P value set at <0.05.ResultsMedian age of the donors was 34 years (IQR 31–39). First-degree relatives were majority(84.5%). Renal function assessment was done using mean glomerular filtration rate (GFR) from the radionuclide scan (DTPA) and serum creatinine levels. The donors had a mean GFR of 99.2 ± SD 6.6. All the haematological and biochemical tests were within normal. Majority(42.9%) were HLA compatible, but data on HLA typing was missing for 22% of the patients records. On CT angiogram, single renal artery and single renal vein were found in 94 and 88% respectively. Immediate complications included excessive bleeding(2%) and breach of other cavities (4%). Paralytic ileus (32%) and atelectasis (27%) were the most common early postoperative complications. There was no mortality.ConclusionOur study reports no fatality but significant post-operative complications. These are significant findings that may be used to review and improve care and to educate potential kidney donors on the safety of this procedure in our centre, in a bid to widen the pool of potential living kidney donors.
Highlights
Kidney transplantation is the renal replacement therapy of choice for end stage renal disease
In Sub Saharan Africa, patients with end-stage renal disease (ESRD) are relatively young, ranging between 20 and 50 years compared to the developed world who are elderly [4, 5]
During the study period 118 were screened as potential donors but only 101 kidney donations took place
Summary
Kidney transplantation is the renal replacement therapy of choice for end stage renal disease. The incidence of end-stage renal disease (ESRD) is consistently increasing, currently standing at 6% per year [1]. In most parts of Africa, maintenance haemodialysis is beyond the reach of most people due to cost and shortage of dialysis centres [7]. This is compounded by lack of living donors, laws that do not allow for cadaveric donors, few transplant surgeons and prohibitive costs of anti-graft rejection drugs [8,9,10]
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