Outcomes of Kidney Transplantation in Children Aged 0-18years in Kenya

Abstract

Background: The treatment of choice for paediatric patients diagnosed with end-stage renal disease is now kidney transplantation (KT) . There is no data on the survival and graft failure rates of children receiving kidney transplants at Kenyatta National Hospital (KNH) or Moi Teaching and Referral Hospital (MTRH). Objective: The primary objective was to determine the 5-year survival rate in children who underwent renal transplant in KNH/MTRH. Design and Methods: Retrospective case series using medical records of all paediatric patients (0-18yrs) who have undergone kidney transplantation at KNH and MTRH at the Kenyatta National Hospital (KNH) between 2006 and 2021. Result: A total of 25 of children underwent renal transplant surgery KNH (n=10) and MTRH (n=15). The 5-year survival rate for paediatric renal transplant patients was 88.9 % and 80% at MTRH and KNH respectively. Beyond the five-year mark, the survival rate for patients at MTRH drops lower than the survival rate at KNH. . Three and one deaths occurred at KNH and MTRH respectively. One patient died two years post-transplant due to severe metabolic acidosis secondary to recurring ESRD. Another patient had acute renal dysfunction two years post-transplant demonstrated by rising creatinine levels and died three years post-transplant. A third transplant patient died two years post-transplant while waiting for re-transplantation. The final patient who died had worsening renal function two years after renal transplantation and was lost to follow-up. One-year survival rate of graft function at both MTRH and KNH was over 95% …. At 5 years the graft survival rate in both hospitals declined to just below 60% at MTRH and approximately 70% KNH. The 10 years graft survival rate was approximately xx. Conclusion and Recommendation: The 5-year survival rate following paediatric renal transplant at KNH and MTRH was XX and YY with an overll survival of XX. Graft rejection rates were low in the first year and rose to nearly XX at 5 years.