Low Asia kidney transplant rate persists despite increase in end-stage disease

The prevalence of end-stage kidney disease (ESKD) in Asia is increasing, with the region having one of the highest incidence rates globally. Despite kidney transplantation being the preferred treatment for ESKD, Asia has been slow to embrace this option. In 2018, the median rates of deceased donor kidney transplantation (DDKT) in East and North Asia, Southeast Asia, and West Asia were significantly lower compared to the global average.

A team of international researchers, including clinicians from various Asian countries, published a paper in The Lancet Regional Health – Southeast Asia, addressing the challenges and policies affecting DDKT in Asia. The authors proposed the need for a regional policy accompanied by support systems, particularly in lower-income countries, where national policies are lacking. Without such policies, there is a risk of illegal organ transplantation and the exploitation of vulnerable communities. The success of DDKT programs in Asia depends on strengthening local transplant infrastructure, improving public engagement, coordinating multi-sectorial support, and establishing legislative jurisdictions.

The unique population demographics, including diverse ethnic, cultural, and religious heterogeneity, present further challenges in implementing DDKT programs in Asia. Disparities in national populations, geographical sizes, income status, and health funding mechanisms also contribute to the barriers. The primary goal of DDKT policies is to increase transplantation rates through regulated and coordinated channels. The World Health Organization (WHO) has emphasized the importance of developing DDKT programs to maximize their therapeutic potential and work towards self-sufficiency in transplantation. The regional approach aims to expand the DDKT program while increasing donation, improving education and infrastructure, fostering international collaboration, and ensuring ethical sustainability.

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