坦桑尼亚穆希比利国家医院肾移植的临床特征和结果。

Clinical profile and outcome of kidney transplantation at Muhimbili National Hospital, Tanzania.

机构信息

Renal Unit, Department of Internal Medicine, Muhimbili National Hospital, Dar es Salaam, Tanzania.

School of Clinical Medicine, College of Medicine, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.

出版信息

BMC Nephrol. 2024 Sep 28;25(1):323. doi: 10.1186/s12882-024-03765-x.

DOI:10.1186/s12882-024-03765-x

PMID:39342167

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11439196/

Abstract

BACKGROUND

Kidney transplantation is the definitive treatment option for chronic kidney failure, offering improved quality of life and extended survival. Access to kidney transplantation is limited in the Sub-Saharan Africa (SSA) region, with only a few countries with established services. Tanzania started its program five years ago, for the sustainability of the program it is important to understand the outcome. Therefore, this study was conducted to determine the clinical outcomes and survival rates of kidney transplant recipients at Muhimbili National Hospital in Tanzania, in the absence of a national transplant registry, since the inception of the program.

METHODS

This was a retrospective study conducted among kidney transplant recipients from live donors at Muhimbili National Hospital (MNH) between November 2017 and February 2022. Analyses were performed to assess baseline characteristics, post-transplant complications, and patient and graft survival.

RESULTS

In our study of 68 kidney transplant recipients, the majority of recipients were male (63.2%) with a mean age of 45.8 years and under medical insurance (88.2%). The predominant cause of CKD was hypertension (58.2%) with recipients undergoing dialysis for a mean duration of 14.4 months, and basiliximab being the most commonly used induction medication (57.3%). The majority of donors were males (64.7%) and had first-degree relationships with recipients (76.5%). Haploid HLA mismatch was observed in 36.8% of cases. One-year patient and graft survival rates were 91.2% and 96.7%, respectively, with infection being the primary cause of death (n = 5), and more than half of deceased patients died with a functioning graft (n = 4).

CONCLUSION

Our study underscores favorable one-year patient and graft outcomes among kidney transplant recipients at Muhimbili National Hospital, Tanzania. However, challenges persist, notably with infections posing ongoing difficulties for this cohort.

摘要

背景

肾脏移植是慢性肾衰竭的最终治疗选择，可提高生活质量并延长生存时间。在撒哈拉以南非洲（SSA）地区，肾脏移植的机会有限，只有少数几个国家有成熟的服务。坦桑尼亚五年前开始了该项目，为了确保该项目的可持续性，了解其结果非常重要。因此，本研究旨在确定坦桑尼亚穆希比利国家医院（MNH）活体供者肾移植受者的临床结果和生存率，由于没有国家移植登记处，本研究自项目启动以来一直在进行。

方法

这是一项回顾性研究，研究对象为 2017 年 11 月至 2022 年 2 月期间在 MNH 接受活体供者肾移植的肾移植受者。进行分析以评估基线特征、移植后并发症以及患者和移植物的生存率。

结果

在我们的 68 例肾移植受者研究中，大多数受者为男性（63.2%），平均年龄为 45.8 岁，且有医疗保险（88.2%）。CKD 的主要原因是高血压（58.2%），受者接受透析的平均时间为 14.4 个月，最常使用的诱导药物是巴利昔单抗（57.3%）。大多数供者为男性（64.7%），与受者有一级亲属关系（76.5%）。HLA 单倍型错配率为 36.8%。患者和移植物的 1 年生存率分别为 91.2%和 96.7%，感染是导致死亡的主要原因（n=5），超过一半的死亡患者移植物仍在发挥功能（n=4）。