Outcomes of renal transplantation in Africa: a systematic review and meta-analysis.
Although transplantation is considered a treatment for end-stage renal disease, data on post-transplant outcomes remain fragmented.
This study aims to assess the outcomes of renal transplantation in Africa.
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 I 2 test, and publication bias was evaluated using Egger's regression test. Trim-and-fill analysis was employed to manage publication bias. The protocol was registered in the International Prospective Register of Systematic Reviews.
Studies conducted in Africa.
In this study, 16 articles were included, with a total of 3617 participants.
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.
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.
This study aims to assess the outcomes of renal transplantation in Africa.
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 I 2 test, and publication bias was evaluated using Egger's regression test. Trim-and-fill analysis was employed to manage publication bias. The protocol was registered in the International Prospective Register of Systematic Reviews.
Studies conducted in Africa.
In this study, 16 articles were included, with a total of 3617 participants.
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.
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.
Authors
Belay Belay, Eshetie Eshetie, Ewunetu Ewunetu, Amare Amare, Kassaw Kassaw, Aytenew Aytenew, Tilaye Tilaye, Mekonnen Mekonnen, Belete Belete, Abere Abere
View on Pubmed