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Challenges in the management of kidney transplant recipients in a centre without a kidney transplant program: A single centre experience

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.