Kidney transplant crisis exposed

Chronic kidney failure involves a gradual loss of kidney function. [iStockphoto]

Kenya faces a severe shortage of kidney specialists, a new Ministry of Health report reveals.

The report notes that most transplant facilities, especially in urban areas, share key personnel, including urologists, vascular surgeons, nephrologists, and anesthesiologists, due to the limited pool of specialists.

Of the eight facilities offering kidney transplants, only Kenyatta National Hospital (KNH), Moi Teaching and Referral Hospital (MTRH), and MP Shah had Kenyan specialists.

The others, Nairobi West, St Luke's Orthopaedic, Aga Khan, Kenyatta University Teaching, Referral and Research Hospital, Mediheal, and Nairobi Hospital, relied on visiting or temporary experts mainly from India, Libya, Uganda and Egypt.

The report faults most facilities for failing to follow regulations set by the Kenya Renal Association before and after transplant procedures. Only KNH, MTRH, and Aga Khan had fully constituted transplant teams.

Data from the committee shows Mediheal performed the highest number of transplants, 416 between January 2020 and March 2025, followed by KNH (86), MTRH (71), St Luke's (50), Nairobi Hospital (40), MP Shah (30), Nairobi West (11), Aga Khan (9), and Kenyatta University Teaching Hospital (2).

Capacity building

KNH and MTRH were praised for programmes aimed at skills transfer to emerging transplant centres. Aga Khan was commended for using separate teams for donors and recipients, helping to avoid ethical conflicts.

However, most hospitals lacked policies on capacity building and transplant-specific training opportunities. While KNH, MP Shah and Aga Khan had independent donor lawyers, other facilities assigned lawyers who were institution employees, raising conflict of interest concerns.

In many facilities, donors and recipients were not provided with specific consent forms detailing procedures, risks, or long-term outcomes. Some surgeries proceeded with incomplete or improperly signed consent forms, often in English without translation services.

At Mediheal, the report found that in some cases, donor consent forms were witnessed by the intended recipients-raising concerns of coercion.

Only KNH, MP Shah, MTRH, and Aga Khan followed up with both donors and recipients. Kenya has just one histocompatibility testing lab, located at KNH, while other hospitals outsourced tests to India or South Africa. Most facilities lacked transplant-specific ethics committees or clear policies to prevent trafficking. Reporting structures for suspicious activity were also missing.

Out of 454 patient files reviewed, 370 were from Mediheal. Notably, 44 per cent of foreign donors were from Azerbaijan, 51 per cent of foreign recipients were Israeli, and 85 per cent of unrelated donor-recipient transplants occurred at Mediheal.