Challenges accessing kidney transplantation in Lagos,Nigeria

Background: Kidney transplantation (KT) is the best form of treatment for end-stage renal disease (ESRD); however, worldwide, there are potential barriers along the pathway to transplantation. Objective: The aim of this study was to identify the major impediments to KT programme in Lagos, Nigeria. Materials and Methods: This was a cross-sectional, descriptive study of patients with ESRD who have been on regular dialysis for at least 3 months at the Lagos University Teaching Hospital from January 2012 to December 2014. Using pretested questionnaire, relevant clinical and demographic information was obtained including the challenges faced with access to kidney transplant programme. Results: Fifty-seven patients were recruited, of which 30 (52.6%) were male, with a mean age of 40.6 ± 12.8 years. The common aetiologies of ESRD were hypertension (40.4%) and chronic glomerulonephritis (26.3%). The mean duration on dialysis was 8.7 ± 5.84 months (range, 3–28 months). The greatest challenges were lack of donors and lack of funds in 38.5% concurrently, whereas 25% said that they had donors but lack the funds, 5.8% had funds but no donor and 7.7% said that they were not psychologically prepared for kidney transplant at the time of the study. Conclusion: The greatest challenge to KT in Nigeria was scarcity of both donors and funds. Government and health insurance agencies should incorporate renal replacement therapy into their policies. The donor pool could be expanded through establishment of deceased-donor transplant programme in Nigeria.