Renal transplantation remains the most effective treatment of End Stage Renal Failure (ESRF). In this cross sectional study we explore the reasons behind refusal of renal transplantation among adults’ Sudanese haemodialysis patients. The subjects of the study are ESRF adults’ patients on regular haemodialysis treatment in 15 haemdoialysis centres in Khartoum/Sudan. All patients who are on regular haemodialysis were interviewed by questionnaire to explore the reasons of refusal of renal transplantation. A total of 1583 ESRF adults’ patients on regular haemodialysis have been participated in the study, 381 (24.1%) patients refused kidney transplantation. The mean age of patients refusing kidney transplantation was (58.5 + 15.1 years); 77.4% of them were ≥50 years old, 59.2% were males and 88.1% were unemployed, patients older than 50 years old and unemployed are tend to refuse renal transplantation (P < 0.001). The main reason of refusal was that the patients refuse to accept kidney from living donors (34.8%). 17.6% of patients decline kidney transplantation because of financial reason, 18.1% of patients refused to do transplantation because of fear of transplant surgery, 15.7% of patients believe that kidney transplantation is against their religious values, 11.9% of patients refused transplantation because they don’t have enough knowledge on renal transplantation, only 0.5% of patients refuse transplantation because of side effect of immunosuppressive drugs. In conclusion, in this study we found that elderly and unemployed ESRF patients tend to refuse renal transplantation, the most important reason behind refusal of renal transplantation is refusal of accepting kidney donation from living related donors. This reflects the need for development of cadaveric donors program in the Sudan. ESRF patients need education and counseling on renal transplantation.
Suliman, S.M., Beliela, M.H. and Hamza, H. (1995) Dialysis and Transplantation in Sudan. Saudi Journal of Kidney Diseases and Transplantation: An Official Publication of the Saudi Center for Organ Transplantation, Saudi Arabia, 6, 312-314.
Abdelwahab, H.H., Shigidi, M.M.T., Ibrahim, L.S. and El-Tohami, A. (2013) Barriers to Kidney Transplantation among Adult Sudanese Patients on Maintenance Hemodialysis in Dialysis Units in Khartoum State. Saudi Journal of Kidney Diseases and Transplantation, 24, 1044-1049. http://dx.doi.org/10.4103/1319-2442.118093
Nizic-Kos, T., Ponikvar, A. and Buturovic-Ponikvar, J. (2013) Reasons for Refusing Kidney Transplantation among Chronic Dialysis Patients. Therapeutic Apheresis and Dialysis, 17, 419-424. http://dx.doi.org/10.1111/1744-9987.12090
Maglakelidze, N., Pantsulaia, T., Tchokhonelidze, I., Managadze, L. and Chkhotua, A. (2011) Assessment of Health-Related Quality of Life in Renal Transplant Recipients and Dialysis Patients. Transplantation Proceedings, 43, 376-379. http://dx.doi.org/10.1016/j.transproceed.2010.12.015
Balaska, A., Moustafellos, P., Gourgiotis, S., Pistolas, D., Hadjiyannakis, E., Vougas, V. and Drakopoulos, S. (2006) Changes in Health-Related Quality of Life in Greek Adult Patients 1 Year after Successful Renal Transplantation. Experimental and Clinical Transplantation: Official Journal of the Middle East Society for Organ Transplantation, 4, 521-524.
Kabbali, N., Mikou, S., El Bardai, G., Tazi, N., Ezziani, M., Batta, F., Arrayhani, M. and Houssaini, T. (2014) Attitude of Hemodialysis Patients toward Renal Transplantation: A Moroccan Interregional Survey. Transplantation Proceedings, 46, 1328-1331. http://dx.doi.org/10.1016/j.transproceed.2014.03.008
Buturovic-Ponikvar, J., Gubensek, J., Arnol, M., Bren, A., Kandus, A. and Ponikvar, R. (2011) Dialysis Patients Refusing Kidney Transplantation: Data from the Slovenian Renal Replacement Therapy Registry. Therapeutic Apheresis and Dialysis, 15, 245-249. http://dx.doi.org/10.1111/j.1744-9987.2011.00945.x
Weitz, J., Koch, M., Mehrabi, A., Schemmer, P., Zeier, M., Beimler, J., Büchler, M. and Schmidt, J. (2006) Living-Donor Kidney Transplantation: Risks of the Donor—Benefits of the Recipient. Clinical Transplantation, 20, 13-16. http://dx.doi.org/10.1111/j.1399-0012.2006.00595.x
Schold, J.D., Gregg, J.A., Harman, J.S., Hall, A.G., Patton, P.R. and Meier-Kriesche, H.-U. (2011) Barriers to Evaluation and Wait Listing for Kidney Transplantation. Clinical Journal of the American Society of Nephrology, 6, 1760-1767. http://dx.doi.org/10.2215/CJN.08620910
Wolfe, R.A., Ashby, V.B., Milford, E.L., Ojo, A.O., Ettenger, R.E., Agodoa, L.Y., Held, P.J. and Port, F.K. (1999) Comparison of Mortality in All Patients on Dialysis, Patients on Dialysis Awaiting Transplantation, and Recipients of a First Cadaveric Transplant. New England Journal of Medicine, 341, 1725-1730. http://dx.doi.org/10.1056/NEJM199912023412303
Evans, R.W., Manninen, D.L., Garrison Jr., L.P., Hart, L.G., Blagg, C.R., Gutman, R.A., Hull, A.R. and Lowrie, E.G. (1985) The Quality of Life of Patients with End-Stage Renal Disease. New England Journal of Medicine, 312, 553-559. http://dx.doi.org/10.1056/NEJM198502283120905
Nadoushan, M.S., Heshmati, B.N., Pirsaraee, A.S., Nodoushan, I.S., Nadoushan, R.J. and Yazdi, F. (2014) Knowledge and Attitude of Iranian Physicians towards Organ and Tissue Donation. International Journal of Organ Transplantation Medicine, 5, 66-70.