An Overview of the Long-term Follow-up of the Adult Post-kidney Transplant Recipients in Sudan: A Single-Center Experience

Abstract

Kidney transplant remains the definitive treatment for patients with end-stage renal disease. A retrospective cohort was conducted in Dr. Selma Center for Kidney Diseases (DSCKD) to determine the pattern of follow-up and outcomes of adult kidney transplant recipients (KTRs) on long-term follow-up. Patients presented for follow-up during the period from January to June 2018 were studied regarding their demographic features, kidney transplant surgery, immunosuppressive therapy, graft function, and post-transplant complications. Data analysis was done using the Statistical Package for the Social Sciences version 16.0. During the study period, a total of 941 adult and pediatric KTR presented to DSCKD for follow-up. Only 792 KTRs were included in the study; those were adults, with their first kidney transplant, completed one year post-transplant, and agreed for enrollment. The mean age of the studied population was 47 ± 4.3 years. The majority were males, 74.2%. The median duration of follow-up was 7.4 years (interquartile range 3–11). Most transplants were through living-related donations, 78.8%. The combination of prednisolone, tacrolimus, and azathioprine remains the most common immunosuppressive regimen prescribed; delivered to 47.5% of recipients. Post-transplant complications were predominantly recurrent infections, diabetes mellitus, and hyperlipidemia seen in 54.5%, 42.4%, and 24.7% of recipients, respectively. On cross-comparisons living unrelated donor transplant recipients were found to have increased post-transplant complications, with a reduced kidney graft function at the end of the 1st year and throughout follow-up, when compared to living related donor transplant recipients. A prospective multi-center study with long-term follow-up remains essential for further evaluation of the long-term outcomes of the KTR in Sudan.