Kidney transplantation in sub-Sahara African countries: challenges and lessons from the experience of Cameroon: a preliminary report of the first 17 pioneer cases

This report presents the outcomes, challenges, and lessons learned from the first 17 cases of kidney transplantation (KT) performed in Cameroon and the Central Africa sub-region. All patients who underwent kidney transplantation at the Yaoundé General Hospital (YGH) are included in this study. Seventeen kidney transplants were performed, nine females and eight males. All donors were family members. The underlying nephropathies were chronic glomerulonephritis (9 cases), hypertensive nephropathy (6 cases), and Unknown origin (4 cases). Immunological compatibility was categorized as follows: HLA-identical (7 pairs), HLA-different (3 pairs), haploidentical (6 pairs), homozygous twin sisters (1 pair) and HLA semi-identical (1 pair). After transplantation, two recipients experienced complications due to an incorrect ureteral implantation into the peritoneum (1 case), and an anastomotic leak (hematoma), another case. All our patients are currently alive, with good quality of life and stable renal function. The treatment protocol was by induction therapy; basiliximab (20 mg on days 0 and 4) or Thymoglobulin, combined with methylprednisolone while maintenance therapy included mycophenolic acid, cyclosporine or tacrolimus, and prednisone. The total cost of patient management, including immune compatibility testing for the first patients, was covered by YGH and its partners. In conclusion, kidney transplantation is a safe and effective treatment in Cameroon. The team at YGH, along with international collaborators, have successfully acquired the necessary technology, and expertise, to perform kidney transplantation, making it a viable option for patients.