PATIENT AND GRAFT SURVIVAL RATES AT FIVE YEARS FOLLOWING KIDNEY TRANSPLANTATION IN ETHIOPIA

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PATIENT AND GRAFT SURVIVAL RATES AT FIVE YEARS FOLLOWING KIDNEY TRANSPLANTATION IN ETHIOPIA

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Co-author 1

Solomon Tamiru Amade solo.tame.23@gmail.com Saint Peter's Specialized Hospital Internal Medicine, Nephrology Unit Addis Ababa Ethiopia *

Co-author 2

Leja Hamza Juhar lejahamza@yahoo.com Saint Paul's Hospital Millennium Medical College Internal Medicine, Nephrology Unit Addis Ababa Ethiopia -

Co-author 3

Ermiyas Mullu ermiyasmuller@gmial.com Saint Paul's Hospital Millennium Medical College School of Public Health Addis Ababa Ethiopia -

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Introduction

In Ethiopia living donor kidney transplantation was started in September 2015 at the National Transplantation Center. The center was established in Saint Paul Hospital Millennium Medical College (SPHMMC) in collaboration with the Ethiopian Federal Ministry of Health and Michigan University. One year death censored graft survival rate was 98.5%. This study was conducted to determine five-year patient and graft survival among the cohort of recipients operated from September1 2015 to November 15 2018.

Methods

A retrospective study of the cohort was conducted. Recipient and donor data were collected from the medical records using a structured printed tool. The collected data were entered and analyzed using IBM SPSS statistics version 29.0.2.0. Five-year graft and patient survival rates were determined. Predictors of five year patient and graft survival were identified using logistic regression. Ethical clearance was obtained from the institutional review board of SPHMMC

Results

Ninety two recipients were included. Mean + SD age was 34.07 + 11.26 years. Sixty-four (68.8%) were male. Mean + SD age of donors was 34.9 + 11.9 years. All except 9 (9.8%) were related to the recipient. Basiliximab was the induction regimen for 93.5%. Tacrolimus, MMF and prednisolone were maintenance immunosuppressive for 95% of recipients. Five year patient survival was 83.7%. Age > 40 years, longer duration of post-op admission, serious infection during follow-up, graft rejection and graft biopsy predicted significantly reduced five year patient survival. OR (95% CI) were 0.19 (0.05-0.77), 0.92 (0.86 - 0.99), 0.06 (0.01 - 0.47), 0.14(0.03-0.64) and 0.21(0.06 - 0.74) respectively. Tertiary education predicted better five year patient survival OR (95% CI) 6.73(1.16-39.09). Five year death censored graft survival was 90%. Donor 24 hour urinary protein level, record of graft rejection and number of hospital admissions predicted reduced five year death censored graft survival with OR (95% CI) of 0.98 (0.96 – 0.99), 0.01(0.001-0.1) and 0.39 (0.22 – 0.71) respectively.

Conclusion

Five year survival rate of recipients at the National Transplantation Center of Ethiopia is acceptable. The death censored graft survival rate at five years is comparable to those in developed regions.

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