Outcomes, eligibility, and waiting time for cadaveric kidney transplantation in Qatar: a national study

Kidney transplantation is the optimal treatment for end-stage kidney disease (ESKD); however, access to transplantation remains limited by donor availability. Data on transplant evaluation outcomes and waiting times in the Middle East are scarce. This study aimed to assess eligibility for kidney transplantation, outcomes of referred patients, waiting time to cadaveric transplantation, and factors associated with receiving a cadaveric kidney transplant in Qatar.

We conducted a retrospective cohort study of adult patients with ESKD referred for kidney transplant evaluation at the national transplant center in Qatar between 2003 and 2017. Patients were assessed for transplant suitability through a multidisciplinary process. Among those listed for cadaveric transplantation, outcomes included transplantation, death, or remaining on the waiting list. Multivariable logistic regression was used to identify factors associated with undergoing cadaveric transplantation.

A total of 1201 patients were referred, of whom 835 (69.5%) completed transplant evaluation. Among these, 797 (95.4%) were deemed suitable for transplantation, while 38 (4.6%) were rejected, primarily due to advanced age or cardiovascular disease. Of eligible patients, 361 (45.3%) underwent living donor transplantation, and 436 were listed for cadaveric transplantation. During the study period, 84 patients (19.3%) received a cadaveric transplant after a mean waiting time of 1.79 ± 1.71 years, 59 (13.5%) died, and 293 (67.2%) remained on the waiting list. In multivariable analysis, peritoneal dialysis was associated with a higher likelihood of transplantation (p = 0.003).

Most patients referred for kidney transplantation in Qatar were deemed suitable; however, access to cadaveric transplantation remained limited. While waiting time among transplanted patients appeared relatively shorter compared to some international settings, a substantial proportion of patients remained on the waiting list or died before transplantation. The association between peritoneal dialysis and transplantation likely reflects underlying differences in patient characteristics rather than a causal effect.