Kidney transplantation in low- and middle-income countries: the Transplant Links experience

Area of Science:

• Nephrology
• Transplant Surgery
• Global Health

Background:

• Paediatric kidney failure causes significant childhood morbidity and mortality worldwide.
• Kidney transplantation is the optimal treatment, but access is limited in low- and middle-income countries (LMICs).
• The Transplant Links Community (TLC) supports LMICs in developing self-sufficient pediatric kidney transplant programs.

Purpose of the Study:

• To review TLC's 15-year experience in establishing pediatric kidney transplantation in LMICs.
• To identify challenges encountered during the development of these services.
• To highlight ongoing barriers to global pediatric transplantation.

Main Methods:

• Review of first-hand experience from Transplant Links Community (TLC) mentoring programs.
• Analysis of challenges in establishing and maintaining pediatric transplant services.
• Identification of specific barriers unique to pediatric programs in LMICs.

Main Results:

• Numerous challenges exist in initiating and sustaining kidney transplant services.
• Specific barriers hinder the establishment of pediatric transplant programs compared to adult ones.
• Progress in LMICs requires addressing these identified ongoing barriers.

Conclusions:

• Developing pediatric kidney transplantation in LMICs is complex and faces unique hurdles.
• Sustained mentorship and targeted interventions are crucial for success.
• Addressing identified barriers is essential for improving global access to pediatric kidney transplants.