Worldwide organization and structures for kidney transplantation services.

Area of Science:

• Nephrology
• Transplantation Medicine
• Global Health

Background:

• Kidney transplantation (KT) offers superior outcomes compared to dialysis for kidney failure.
• Evaluating the global landscape of KT services is crucial for improving patient care.

Purpose of the Study:

• To assess the worldwide epidemiology of kidney transplantation.
• To determine the accessibility and availability of KT services globally.

Main Methods:

• An international survey of stakeholders (clinicians, policymakers, patient advocates) was conducted.
• Data collected from 167 countries via the International Society of Nephrology network.
• Survey focused on KT availability, access, donor types, and costs.

Main Results:

• KT services are available in 70% of surveyed countries, significantly lower in low-income nations (21%).
• Access to KT is more prevalent in adults than children across 80% of countries.
• Significant disparities exist in KT prevalence, incidence, pre-emptive KT, and costs, with low-income countries facing major limitations.

Conclusions:

• Global availability, access, and affordability of kidney transplantation remain critically limited, particularly in low-income countries.
• Urgent development of strategies is required to ensure equitable access to KT for all patients with kidney failure worldwide.