Chronic kidney disease is worldwide public health problem. Inaccessibility for treatment is common in developing countries. In Madagascar, among patients with end stage renal disease, less than 3% have an accessibility for kidney transplantation. The goal of the study is to determine the characteristics of the patients who benefitted kidney transplantation. We have conducted one retrospective study in two centers in the Capital. We included all patients kidney transplanted from 1st of January 1987 to 31st of December 2016. All characteristics of the patients before and after kidney transplantation were recorded. We followed patients for one year. A total of 27 patients kidney transplanted were included. Mean age were 43.5 ans. Sex-ratio were 1.2. In 85.2%, Kidney transplantation were done in patients from rich socioeconomic categories. All transplantation were done with living and relatives donors and were done abroad (India, Egypt and south Africa). Creatinine level of recipient were respectively 837Umol/l and 97Umol/l before and after kidney transplantation. Wysolone, tacrolimus and mucophenolate mofetil were the most useful immunosuppression therapy. Survival rate one year after transplantation were 96.3 %. Madagascar’s kidney transplantation rate is very low because of non-availability of the transplantation surgery in the country. There are also some reasons as lack of legal framework, public opinion strongly influenced by the fear of organ trafficking, some religious aspects and lack of trained specialists, and laboratories infrastructures. Our challenge is to practice the surgeon in Local Hospital. To rich the goal, mental, ethical, professional, infrastructure challenges must be first of all considered.
