Events - ISN-TTS Webinar: Paediatric transplantation in Tanzania, our experience, outcomes and challenges

Tanzania established its first National Kidney Transplantation Programme at Muhimbili National Hospital (MNH) on 21st November 2017. Paediatric kidney transplantation was initiated in 2019. The prevalence of chronic kidney disease (CKD) in Tanzanian children is unknown; however, approximately 10% of paediatric CKD patients attending our clinics have end-stage renal disease (ESRD). Although paediatric haemodialysis and acute peritoneal dialysis services exist in Tanzania, access remains limited, and many children with CKD succumb to complications of kidney failure. 

In this webinar, the presenters will share experiences, outcomes, and challenges in paediatric kidney transplantation at MNH. Between 2019 and 2023, four children underwent living-related kidney transplantation (2 in 2019, 2 in 2023). The cohort included 2 males and 2 females, with a median age of 10 years (range 4–13). Preoperative dialysis was required in three patients (75%), while one patient received a pre-emptive transplant. Three transplants were performed at MNH, and one was done outside Tanzania. Donors were mothers in 75% of cases. 

Three recipients (75%) had steroid-resistant nephrotic syndrome, and one had polycystic kidney disease. Only one patient underwent a native kidney biopsy pre-transplant. Induction therapy included basiliximab and methylprednisolone, while maintenance immunosuppression consisted of tacrolimus, mycophenolate mofetil, and prednisolone. One graft was lost at 18 months due to non-adherence, and the patient subsequently died on haemodialysis. The remaining patients have stable graft function to date, with follow-up ranging from 3 months to 5 years. 

This webinar will highlight the feasibility of paediatric kidney transplantation in a low-resource setting, review outcomes, and discuss challenges including late presentation, limited dialysis access, and non-adherence.