Outcomes of Kidney Transplant Recipients Followed Up in Burkina Faso: A 10-Year Multicentre Cohort Study of Patients Transplanted Abroad in the Absence of a National Program

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Résumé

Introduction. In sub-Saharan Africa, kidney transplantation remains inaccessible in most countries, forcing patients to seek transplantation abroad. Burkina Faso has no national transplantation programme, and transplant recipients returning to the country face challenges in follow-up, immunosuppressant access, and complication management. This study aimed to describe the clinical profile, complications, and survival of kidney transplant recipients followed up in Burkina Faso after transplantation abroad. Methods. We conducted a retrospective, descriptive, multicentre cohort study from January 2013 to January 2023 in the five nephrology departments of Burkina Faso. All kidney transplant recipients transplanted abroad and followed up in Burkina Faso were included. Data were extracted from medical records, with missing information completed by telephone interview or home visit. Survival was estimated using the Kaplan–Meier method. The threshold for statistical significance was set at p < 0.05. Results. Forty-four patients were included (sex ratio M/F = 3.9; mean age 47.5 ± 10.5 years). The initial nephropathy was undetermined in 90.9% of cases. Transplantation was performed in Côte d'Ivoire and Turkey (40.5% each), in private centres (95.2%), from living related donors. The follow-up schedule was respected by 64.1% of patients. Infectious complications predominated (47.7%). No rejection was documented, owing to the unavailability of biopsy. Patient survival was 100% at 6 months, 94.0% at 12 months, and 70.3% at 60 months; death-censored graft survival was 100%, 97.1% and 84.9% at the same time points. Conclusion. One-year survival was satisfactory but deteriorated over the long term. These findings support the establishment of a national transplantation programme and the need to secure immunosuppressant supply and strengthen post-transplant follow-up capacity in Burkina Faso.

Mots-clés

Kidney transplantation, post-transplant follow-up, Graft survival, Immunosuppressive agents, Sub-Saharan Africa