Introduction: Kidney transplant is the preferred renal replacement therapy of choice over dialysis as it improves quality of life and reduces mortality. In sub-Saharan Africa, kidney transplants are rare due to a lack of resources and the cost of kidney transplants. The induction and maintenance therapies contribute to the high cost during and post-kidney transplant. We present a single-centre experience of a kidney transplant program at a private facility, M.P Shah Hospital, in Nairobi, Kenya. 
Methodology: This is a retrospective survey of all kidney transplants done at the M.P Shah Hospital over five years, from 2018 to 2023. Data was obtained from the files for the patients followed up at the M.P Shah Hospital and from the private nephrologists who were following up with their patients after the kidney transplant. Recipients' and donors' data including age, gender, blood group, HLA mismatches, date of transplant, creatinine on the day of the transplant and the creatinine on the day of discharge was obtained. The creatinine one month post-transplant and whether induction therapy was used was recorded. The proportion of patients who had HLA mismatches of more than three and those who used basiliximab was also obtained.
Results: A total of 32 living kidney transplants were done from June 2018 to December 2023. 81.3% of the recipients and 69% of the donors were males. The age range of recipients was 21-72 years with the mean age being 42.25 years. 21 (67%) donors were aged between 20 and 40 years, and 11 (33%) patients were between 40 and 60 years. 
18 (56.2%) patients had HLA mismatches of more than 3/6. The majority (53.13%) of the recipients were blood group O positive, while one recipient was O negative and one recipient was A negative. 65.36% of the donors were O-positive. 22 (68.7%) recipients received basiliximab as the induction agent, and no patient received anti-Thymocyte globulin or alemtuzumab.
The average length of stay for the recipient was 10.7 days and the average length of stay for the donor was 3.6 days. The average serum creatinine for the recipient one-month post-kidney transplant was 123.9 micromoles per litre. The average serum creatinine for the donor on discharge was 139 micromoles per litre. 1 patient developed delayed graft function that required three dialysis sessions. The kidney biopsy showed acute cellular rejection, which responded to pulsing with methylprednisolone and recovery of graft function.
Conclusion: Due to constrained resources, there are very limited kidney transplant programs in Sub-Saharan Africa. Data from our renal transplant unit shows excellent short-term outcomes without using ATG or alemtuzumab, which is recommended for high-risk transplant recipients, including those with more than 3/6 HLA mismatches. The average length of stay for the recipient and donor was also short, indicating no complications post-transplant. A more extended follow-up study is recommended to look at the long-term outcomes for these patients.