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Published:
Apr 7, 2021DOI:
10.4314/rejhs.v9i1.1Keywords:
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Main Article Content
Challenges in the management of kidney transplant recipients in a centre without a kidney transplant program: A single centre experience
Abstract
Objective: This study is aimed at highlighting the challenges associated with the management of kidney transplant recipients in a centre without a transplant program.
Methods: This is a retrospective study that enrolled all post renal transplant patients seen at Usmanu Danfodiyo University Teaching Hospital (UDUTH), Sokoto, North-western Nigeria between October 2010 and June 2019. Data obtained included cause of renal disease, pre-transplant dialysis details, type of donor, country of the kidney transplant, sponsor, type of maintenance immunosuppression, frequency of follow up, complications and outcome of the kidney transplant. Data obtained was analysed using statistical package for the social sciences software (SPSS) version 25 (IBM Inc. 2010).
Results: Of the 16 patients who were enrolled in this study, 10 (62.5%) were males with a mean age of 36.5 ± 13.2 years. Twelve (75%) subjects reported challenges in obtaining their post-transplant immunosuppressants. Only one (6.25%) subject had allograft biopsy despite the fact that 5 (71.4%) out of the 7 patients that died had allograft dysfunction. The majority of the participants (81.3%) had no serum tacrolimus level test done throughout their follow up period.
Conclusions: The management of post-transplant recipients in our centre is associated with challenges ranging from difficulty in procurement of post-transplant medications, poor laboratory support for monitoring of drug levels and inadequate facilities for management of allograft dysfunction.
Keywords: Kidney transplant; End-stage renal disease; follow-up
French Title: Défis dans la prise en charge des receveurs de transplantation rénale dans un centre sans programme de transplantation rénale: Une expérience dans un seul centre
Introduction : Cette étude vise à mettre en évidence les défis associés à la prise en charge des greffés rénaux dans un centre sans programme de transplantation.
Méthode de l'étude : Il s'agit d'une étude rétrospective qui a recruté tous les patients après transplantation rénale vus à l'hôpital universitaire Usmanu Danfodiyo (HUUD), Sokoto, dans le nord-ouest du Nigéria entre octobre 2010 et juin 2019. Les données obtenues comprenaient la cause de la maladie rénale, les détails de la dialyse de pré-transplantation, le type du donner, du pays de la transplantation rénale, du promoteur et d'immunosuppression. Les données obtenues ont été analysées à l'aide du progiciel statistique du logiciel de sciences sociales (PSLSS) version 25 (IBM Inc. 2010).
Résultat de l'étude : Sur les 16 patients inclus dans cette étude, 10 (62,5%) étaient des hommes avec un âge moyen de 36,5 ± 13,2 ans. Douze (75%) sujets ont signalé des difficultés à obtenir leurs immunosuppresseurs après la transplantation. Un seul sujet (6,25%) a eu une biopsie d'allogreffe malgré le fait que 5 (71,4%) des 7 patients décédés avaient un dysfonctionnement de l'allogreffe. La majorité des participants (81,3%) n'ont eu aucun test du taux de tacrolimus sérique effectué tout au long de leur période de suivi.
Conclusion : La gestion des receveurs post-transplantation dans notre centre est associée à des défis allant de la difficulté à se procurer des médicaments post-transplantation, un soutien de laboratoire médiocre pour la surveillance des niveaux de médicaments et des installations inadéquates pour la gestion du dysfonctionnement des allogreffes.
Mots-clés: Greffe de rein, phase terminale de la maladie rénale
