Abstract:
Kenya, a lower-middle-income country in East Africa, faces a rising burden of
chronic kidney disease (CKD), with an estimated 12,500 individuals suffering
from end-stage renal disease (ESRD). Renal transplantation—the preferred
treatment option for ESRD, remains underutilized. Since the first transplant
in 1978, seven centers have been established, with 829 transplants performed
by 2022. Living-related renal transplants (LRRT) dominate, while deceased
donor renal transplantation (DDRT) is yet to be implemented. Recent data
show improved outcomes, with one-year graft survival rates up to 96%, but
challenges such as acute rejection rates (32.8%) and limited donor outcome
data persist. Barriers include high costs, limited insurance coverage, inade-
quate laboratory infrastructure, and a transplant workforce shortage. Efforts
to establish DDRT programs are underway but are hampered by the absence
of organ procurement systems and insufficient laboratory capabilities. Future
priorities include reducing costs and expanded insurance coverage for trans-
plant care. Investments in laboratory infrastructure, local tissue typing, and
surgical training are essential. Strengthening international collaborations and
public education campaigns can improve donor pools and transplantation ac-
cess. Strategic policy reforms and resource allocation are vital to scaling up
Kenya’s kidney transplant program and addressing the unmet needs of its
ESRD population.
