Three Years Follow-up of the First Renal Transplant inAminu Kano Teaching Hospital: A Case Report

Abstract

Since the first successful operation in 1954, renal transplant has become the ultimate therapy for end-stage renal disease (ESRD). Unfortunately, it is still unattainable in most developing countries. The first renal transplant in Nigeria was in the year 2000 and there are only three transplant centres currently, with low transplant activity. We report the first renal transplant carried out in our centre and highlight problems of transplantation in Nigeria.

A 23-year-old female undergraduate student with ESRD and her sister, a willing donor, were evaluated and found fit for live related renal transplantation Both donor and recipient workup were done in accordance with the European best practice guidelines (EBPG) except where limitation in our facility did not allow.

The renal transplant was carried out through a right Rutherford - Morison incision, with an end to side anastomosis of the donor renal vessels to the recipient's external iliac vessels. Immune-suppression regime used was cyclosporine, Azathioprine and Prednisolone. Complications encountered in the immediate postoperative period include bleeding from operation site, acute pulmonary oedema and chest infection. Other complications which occurred over the 3-year follow up include; urinary tract Infections. herpes zoster, and cyclosporine toxicity. Other problems encountered were logistic problems such as unavailability of some laboratory facilities in the centre of the assay for cyclosporine.  The patient, however, maintained good graft function 3 years post-transplant.

In conclusion, despite many problems, renal transplantation is a viable option and perhaps the best chance of survival for ESRD patients in developing countries like Nigeria.