Outcomes of renal transplantation in Africa: a systematic review and meta-analysis
Bekalu Mekonen Belay, Yeshiambaw Eshetie, Mengistu Ewunetu, Abraham Tsedalu Amare, Gebrie Kassaw, Tigabu Munye Aytenew, Birara Ayichew Tilaye, Gebrehiwot Berie Mekonnen, Kumlachew Geta Belete, Yirgalem AbereBackground:
Although transplantation is considered a treatment for end-stage renal disease, data on post-transplant outcomes remain fragmented.
Objective:
This study aims to assess the outcomes of renal transplantation in Africa.
Design:
Studies were searched in MEDLINE, EMBASE, CINAHL, Scopus, Google Scholar, the Transplantation Library, and African Journals Online. A random-effects model was employed to calculate the pooled effect size of each outcome. Heterogeneity was assessed with the
Studies:
Studies conducted in Africa.
Participants:
In this study, 16 articles were included, with a total of 3617 participants.
Result:
Pooled mortality among renal transplant recipients was 14.3% (95% CI: 8.77%–19.84%). Graft survival rates at 1 and 5 years were 91.74% (95% CI: 88.56%–94.93%) and 69.15% (95% CI: 57.39%–80.91%), respectively. Patient survival at 1 and 5 years was 94.72% (95% CI: 92.17%–97.26%) and 81.26% (95% CI: 72.11%–90.4%), respectively. Diabetes mellitus, delayed graft function, acute rejection, and infection were observed as post-transplantation complications.
Conclusion:
With a few important exceptions, both graft and patient survival were comparable to reports from other nations. Thus, we recommend that clinical practitioners prioritize infection prevention and early screening for complications. Furthermore, policymakers should develop and implement strategies to prevent and screen for post-transplant complications, and improve the accessibility of the service.