Complications of Kidney Transplantation in a High-Volume Centre in Nigeria: Association Between Repeat Transplants and Infections

Background: Kidney transplantation is the preferred treatment for end-stage kidney disease (ESKD), offering better survival and quality of life compared to dialysis. However, post-kidney transplant complications pose a significant challenge in low-income countries, where access to specialized care, immunological monitoring, and infection control is often limited. Therefore, understanding the complication patterns and associated risk factors in our setting is critical to improving patient outcomes. Methods: We conducted a retrospective review of 149 kidney transplants performed at Zenith Medical and Kidney Centre, Abuja, Nigeria, between January and December 2024. Patient demographics, donor characteristics, and post-transplant outcomes were extracted and analyzed using SPSS version 27. Complication types and their associations were assessed using Chi-square tests. Results: Of the 149 kidney transplant recipients, 67.8% (n = 101) had no reported complications, while 11.4% (n = 17) developed sepsis or infections, 5.4% (n = 8) had allograft dysfunction, and 4.0% (n = 6) experienced hematologic complications. A statistically significant association was found between repeat transplantation and the occurrence of post-transplant complications (p < 0.001). There was no significant association between complications and recipient or donor age, sex, and exposure to hepatitis C virus (HCV) or cytomegalovirus (CMV). Conclusion: The majority of patients did not experience complications within the first year post-transplant. However, repeat kidney transplant was associated with a significantly higher risk of complications. Sepsis was the most frequently reported complication, indicating the need for stricter infection control measures in patients undergoing repeat kidney transplantation. Investing in infection surveillance and long-term patient monitoring may improve post-transplant outcomes in low-income countries.