Causes of Hospital Admission during the First Year Post-Living Donor Kidney Transplantation: A Descriptive Study from a Tanzanian Tertiary Hospital

Abstract

Introduction: Kidney transplantation has significantly improved outcomes for patients with advanced chronic kidney disease (CKD). However, the first-year post-transplant remains a high-risk period for complications and hospital readmissions, particularly in resource-limited settings where specialized care is confined to a few facilities. Methods: This was a retrospective, hospital-based cohort study conducted at Muhimbili National Hospital (MNH) to assess the causes of hospital admissions during the first year following living-related donor renal transplantation between 2017 and 2022. Data were collected from patient medical records and the MNH kidney transplant registry. Categorical and numerical data were summarized using frequencies, percentages, and ranges. Results: A total of 72 patients underwent living-related donor kidney transplantation at Muhimbili National Hospital between 2017 and 2022. The mean age was 45.8 years (SD ±5.2), and the majority were male (65.2%). The most common underlying cause of CKD was hypertension (64.7%), followed by diabetes mellitus (36%). Within the first-year post-transplant, 16.6% (12/72) of patients were readmitted at least once. Among the admissions with known causes (n=6), the leading reasons were ureteric stenosis (n=2), high-grade fevers (n=2), lymphocele (n=1), and hypoglycemia (n=1). Patients with a history of admission had higher mean serum creatinine at 12 months (157.6 ±11.2 µmol/L) compared to those without admissions (123.0 ±9.4 µmol/L). Conclusion: This study found a low rate of hospital admissions during the first year following living-related donor renal transplantation at MNH. Admissions were influenced by both surgical and medical complications, with ureteric stenosis and high-grade fever being the most common causes.