Status Report of Renal Transplant Patients in Niger

Abstract

Kidney transplantation is the treatment of choice for end-stage chronic kidney disease. It improves quality of life and increases life expectancy. At present, Niger is one of the poorest countries in the world does not practice kidney transplantation; thus, patients continue to be referred to other countries for transplantation. This descriptive cross-sectional study was carried out at the Nephrology Department of the National Hospital Amirou Boubacar Diallo in Niamey, Niger over a 5-month period. It included all patients that had benefited from kidney transplantation with the aim to evaluate patient and graft survival. We identified 25 patients. The male to female ratio was 2:1. The average age was 45.4 years ± 11.1 years. The average age of donors was 36.1 years ± 12.6 years with a clear male predominance (17 males to 8 females); all of them were related-donors with 72% of them being brothers or sisters. The causative nephropathy was undetermined in 80% of patients. Sixty-four percent of patients had their kidney transplant in Maghreb, including 16% in Tunisia. The complications were mostly medical (68%), as 20% were immunologic; 8% infectious; 16% metabolic; 20% cardiovascular, and 4% were related to recurrence of the initial nephropathy. Surgical complications involved 6 patients (24%): 5 were vascular cases and one was a urological case. With a median follow-up of 5 years, the patients' survival was 84%, the graft survival was 56%, and death-censored graft survival was 67%. In Niger, after kidney transplantation, the patients' survival is satisfactory, whereas the graft survival is not, mostly due to inadequate follow-up check-ups and prohibitive prices of immunosuppressants.