Background: Progress has been made in the multifactorial field of kidney transplantation over the last two decades. However, the survival of kidney allografts continues to be short for most recipients due to several factors that contribute to kidney allograft loss. This presents with detrimental effects on the outcome of post kidney transplant patients.

Background: Kidney transplantation is the most recommended treatment modality for many patients with end stage renal disease. Kidney transplant recipients need integrated care to provide continuous and coordinated care from pre-transplant to post-transplant phase. Kidney transplant recipients are motivated to adhere to the health care recommendations to improve on the graft life. However, to effectively implement strategies that enhance adherence, it is important to understand the motivators and barriers to self-management among recipients. Objectives: To explore motivators and barriers to selfmanagement among kidney transplant recipients in selected state hospitals in South Africa. Methods: A qualitative case study design was adopted. Purposive sampling method was used to select the study participants. Data was collected through semi-structured interview schedule developed from in-depth literature review. Data was analyzed through thematic template approach. Thematic codes were created based on central research questions during data collection and analysis. Results: The motivators included kidney transplant recipient, physiological, psychological, different support systems and healthcare system related factors. The barriers included kidney transplant recipient, physiological, psychological, healthcare system and socioeconomic status related factors. Conclusion: Exploration of motivators and barriers to selfmanagement among kidney recipients resulted in identification of gaps in kidney transplant management. Understanding the motivators and barriers among kidney transplant recipients towards self-management may allow healthcare professionals to tailor interventions. In addition, the study would inform strategies to promote self-management and behavioral change among kidney transplant recipients towards management. Furthermore, the specific interventions may contribute to improvement of long-term graft survival post kidney transplantation, enhancing improved health status and quality of life.

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Kidney transplantation is the cornerstone for renal treatment in patients with end-stage renal failure. Despite improvements in short-term outcomes of renal transplantation, kidney allograft loss remains a huge challenge. The aim of the study was to assess factors influencing the durability of transplanted kidneys among transplant recipients in South Africa. A descriptive cross-sectional study design was used. A random sampling was used to select 171 participants. Data were collected through structured face-to-face interviews developed from in-depth consideration of relevant literature. Data were coded and entered into the SPSS software, version 24. The entered data were analysed using descriptive and inferential statistics. The results revealed that the average durability of transplanted kidneys was 9.07 years among selected kidney transplant recipients in South Africa. Factors associated with the durability of transplanted kidneys included age, the sewerage system and strict immunosuppressive adherence, all with a P-value = .000, followed by the mode of transport (P-value = .001) and support system (P-value = .004). Other variables including demographics, the healthcare system, medication and lifestyle modification engagement were not associated with the durability of transplanted kidneys. Understanding the factors influencing the durability of transplanted kidneys among kidney transplant recipients in South Africa is crucial. The study revealed associated factors and gaps which may be contributory factors to kidney allograft loss. This study provides an opportunity to introduce specific interventions to nephrology professionals to promote prolonged graft durability. It is recommended that a specific intervention model be developed, which targets South African kidney recipients taking into account the significant variables in this study and the socio-economic status of the country.