A Scoping Review of Kidney Transplantation in Africa: How Far have We Come?

World J Surg. 2023 Sep;47(9):2113-2123. doi: 10.1007/s00268-023-07042-0. Epub 2023 May 9.

Abstract

Introduction: Kidney transplantation is a life-saving treatment for end-stage kidney disease (ESKD) patients. However, access to this treatment in Africa lags behind other regions, leading to significant disparities in care. We aimed to analyse the indications, demographics, and outcomes of kidney transplantation in Africa.

Method: We conducted a systematic review of studies from PubMed, Google Scholar, and African Journal Online using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We pooled and analysed data on procedure type, graft outcomes, donor type, prophylaxis, post-operative complications, and survival from 33 eligible studies.

Result: The most common causes of ESKD requiring transplantation were glomerulonephritis and nephroangiosclerosis. Open nephrectomy was the predominant surgical approach (95%). Living donors accounted for 56.3% (4221) of all donors, with 68.5% being related to the recipient. Cadaveric donors accounted for 43.7% (3280) of transplants. Graft rejection was the most common surgical complication (39.44%), and 60.49% of patients developed hypertension in the follow-up period.

Conclusion: Our study highlights the potential of kidney transplantation to improve the lives of ESKD patients in Africa. However, further research and infrastructure development are necessary to make this treatment more widespread and successful.

Publication types

  • Systematic Review
  • Review

MeSH terms

  • Africa
  • Graft Rejection
  • Graft Survival
  • Humans
  • Kidney Failure, Chronic* / surgery
  • Kidney Transplantation* / adverse effects
  • Living Donors
  • Nephrectomy