title: Living Kidney Donor Transplantation in a Resource-limited Country: The Ivory Coast Experience.
abstract: Renal transplantation that offers a good quality of life still is not performed by the majority of countries of black Africa. We started a pilot project of renal transplantation in Ivory Coast 2 years ago. The present paper reports the preliminary results, difficulties related to the program, and perspectives regarding its expansion. Ten living related kidney transplantations have been performed over a 2-year period. Recipients and their respective donors were male. The mean age of the recipients was 42.8 years (22-57), and the mean age of the donors was 29.4 years (22-43). The mean number of mismatches was 3.2 (0-6). None was immunized. Recipients and donors were all EBV IgG positive and CMV IgG positive. All but 1 case were induced with basiliximab. The mean graft and patient survival time was 16.6 months (6-26). The mean cold ischemic time was 2.27 hours (1-3.32). The mean serum creatinine at discharge was 241.87 μmol/L (115.18-1063.2), at 6 months was 117.20 μmol/l (95.6-139.9), at 12 months was 104.55 μmol/L (62.02-132.9), and at 24 months was 104.55 μmol/L (62.02-132.9). The mean cyclosporine through level (C0) at 6 months was 137.57 ng/mL (70-366), at 12 months was 117.33 ng/mL (62-197), and at 24 months was 78 ng/mL. The mean cyclosporine 2-hour post-administration concentration levels (C2) at 6 months was 764.9 ng/mL (430-1421), at 12 months was 937.17 ng/mL (483-1292), and at 24 months was 690.66 ng/mL (488-853). Main complications were sepsis, adenovirus hemorrhagic cystitis, new-onset diabetes after transplantation, delayed graft function, polycythemia, and cytomegalovirus infection. No clinical rejection was diagnosed over the 2-year period. Patient and graft survival was 100% at a mean post-transplantation time of approximately 16.6 months.
authors: Department of Nephrology and Hemodialysis, Yopougon Teaching Hospital, Abidjan and Pilot Project of Renal Transplantation, Institut de Cardiologie, Treichville Teaching Hospital, Abidjan. Felix Houphouet-Boigny University, Cocody, Abidjan, Ivory Coast. Electronic address: cnackoundoun66@hotmail.fr.
authors: C
authors: C
authors: Ackoundou-N'Guessan
authors: Free University of Brussels, Brussels, Belgium.
authors: A D
authors: AD
authors: Hoang
authors: Free University of Tunis, Charles Nicolle Hospital, Tunis, Tunisia.
authors: T
authors: T
authors: Ben Abdallah
authors: Department of Nephrology and Hemodialysis, Yopougon Teaching Hospital, Abidjan and Pilot Project of Renal Transplantation, Institut de Cardiologie, Treichville Teaching Hospital, Abidjan. Felix Houphouet-Boigny University, Cocody, Abidjan, Ivory Coast.
authors: D A
authors: DA
authors: Gnionsahe
authors: Novartis Pharmaceuticals, Regional Office, Abidjan, Ivory Coast.
authors: I
authors: I
authors: Dollo
authors: Novartis Pharmaceuticals, Regional Office, Abidjan, Ivory Coast.
authors: C
authors: C
authors: Ripoche
authors: Department of Nephrology and Hemodialysis, Yopougon Teaching Hospital, Abidjan and Pilot Project of Renal Transplantation, Institut de Cardiologie, Treichville Teaching Hospital, Abidjan. Felix Houphouet-Boigny University, Cocody, Abidjan, Ivory Coast.
authors: N
authors: N
authors: Coulibaly
authors: Department of Nephrology and Hemodialysis, Yopougon Teaching Hospital, Abidjan and Pilot Project of Renal Transplantation, Institut de Cardiologie, Treichville Teaching Hospital, Abidjan. Felix Houphouet-Boigny University, Cocody, Abidjan, Ivory Coast.
authors: D Y
authors: DY
authors: Aye
authors: Department of Nephrology and Hemodialysis, Yopougon Teaching Hospital, Abidjan and Pilot Project of Renal Transplantation, Institut de Cardiologie, Treichville Teaching Hospital, Abidjan. Felix Houphouet-Boigny University, Cocody, Abidjan, Ivory Coast.
authors: F Y
authors: FY
authors: N'Guessan
authors: Department of Nephrology and Hemodialysis, Yopougon Teaching Hospital, Abidjan and Pilot Project of Renal Transplantation, Institut de Cardiologie, Treichville Teaching Hospital, Abidjan. Felix Houphouet-Boigny University, Cocody, Abidjan, Ivory Coast.
authors: B
authors: B
authors: Diby Kouame
authors: Department of Nephrology and Hemodialysis, Yopougon Teaching Hospital, Abidjan and Pilot Project of Renal Transplantation, Institut de Cardiologie, Treichville Teaching Hospital, Abidjan. Felix Houphouet-Boigny University, Cocody, Abidjan, Ivory Coast.
authors: C M
authors: CM
authors: Guei
authors: Department of Nephrology and Hemodialysis, Yopougon Teaching Hospital, Abidjan and Pilot Project of Renal Transplantation, Institut de Cardiologie, Treichville Teaching Hospital, Abidjan. Felix Houphouet-Boigny University, Cocody, Abidjan, Ivory Coast.
authors: M W
authors: MW
authors: Tia
authors: Department of Nephrology and Hemodialysis, Yopougon Teaching Hospital, Abidjan and Pilot Project of Renal Transplantation, Institut de Cardiologie, Treichville Teaching Hospital, Abidjan. Felix Houphouet-Boigny University, Cocody, Abidjan, Ivory Coast.
authors: Y
authors: Y
authors: Amekoudji
authors: Department of Nephrology and Hemodialysis, Yopougon Teaching Hospital, Abidjan and Pilot Project of Renal Transplantation, Institut de Cardiologie, Treichville Teaching Hospital, Abidjan. Felix Houphouet-Boigny University, Cocody, Abidjan, Ivory Coast.
authors: D A
authors: DA
authors: Lagou
mesh_terms: D000328:Adult; D007560:Cote d'Ivoire; D016572:Cyclosporine / Q000008:administration & dosage; D003586:Cytomegalovirus Infections / Q000188:drug therapy; D046148:Donor Selection; D005260:Female; D006085:Graft Survival; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage; D016030:Kidney Transplantation / Q000379:methods* / Q000706:statistics & numerical data; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D010865:Pilot Projects; D011788:Quality of Life; D051436:Renal Insufficiency, Chronic / Q000601:surgery*; D055815:Young Adult
chemical_list: D007166:Immunosuppressive Agents; D016572:Cyclosporine