title: Outcomes of renal patients from the Ivory Coast transplanted abroad: time for a local kidney transplantation program.
abstract: BACKGROUND
  The outcomes of transplanted kidney recipients from "transplant tourism" have been reported to be alarming. The present study was an attempt to examine the results of renal patients from the Ivory Coast transplanted abroad returning home for follow-up.
  
  
  METHODS
  This retrospective analysis includes renal patients from the Ivory Coast transplanted abroad between 1995 and 2009 and followed up by our nephrology clinic. We collected pre- and posttransplant parameters for statistical analyses.
  
  
  RESULTS
  The 16 patients had a median age of 48 years (range = 32.5-53.75). The median age of kidney donors was 44 years (range = 30.75-51.25). Initial kidney disease was hypertension in 10 patients (62.5%) and diabetes in three patients (18.8%). They received organs from living donors (37.5% related [LRD] and 37.5% unrelated [LURD]). Initial immunosuppression consisted of induction (72.7%), tacrolimus (75%), and mycophenolate mofetil (100%). Two patients (12.5%) experienced late acute rejections, resulting in graft loss. The overall graft survival was 93% at 1 year and 80% at 5 years. Five patients died over the study period, corresponding to an overall mortality rate of 9.25/100 patient-years. The overall median patient survival was 6.25 years (range = 4.19-7.58). Patient survivals at 1 and 5 years were 93% and 53%, respectively. No factors seemed to influence survival (either graft or patient) upon multivariate analysis. Comparison between LRD and LURD recipients revealed no statistical difference among posttransplant characteristics and survivals.
  
  
  CONCLUSIONS
  Mortality of renal patients from the Ivory Coast transplanted abroad is high. Financial exhaustion after transplantation renders follow-up precarious. A local kidney transplantation program in the Ivory Coast appears more urgent than ever.
authors.affiliation: Department of Urology and Nephrology, University of Abidjan, Cocody, Abidjan, Ivory Coast. cnackoundoun@hotmail.com
authors.forename: C
authors.initials: C
authors.lastname: Ackoundou-N'Guessan
authors.forename: D A
authors.initials: DA
authors.lastname: Gnionsahe
authors.forename: A H
authors.initials: AH
authors.lastname: Dekou
authors.forename: W M
authors.initials: WM
authors.lastname: Tia
authors.forename: C M
authors.initials: CM
authors.lastname: Guei
authors.forename: A M
authors.initials: AM
authors.lastname: Moudachirou
mesh_terms: D000328:Adult; D016009:Chi-Square Distribution; D007560:Cote d'Ivoire; D004359:Drug Therapy, Combination; D005260:Female; D006084:Graft Rejection / Q000209:etiology* / Q000401:mortality; D006085:Graft Survival; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D053208:Kaplan-Meier Estimate; D016030:Kidney Transplantation / Q000009:adverse effects* / Q000401:mortality; D019520:Living Donors; D008297:Male; D057193:Medical Tourism / Q000706:statistics & numerical data; D008875:Middle Aged; D009313:National Health Programs; D020380:Needs Assessment; D010043:Outcome and Process Assessment, Health Care / Q000706:statistics & numerical data; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D015996:Survival Rate; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D007166:Immunosuppressive Agents