Asia is experiencing a surge in end-stage kidney disease (ESKD) cases, surpassing other regions in incidence rates. However, the adoption rate of kidney transplantation in Asia remains considerably low compared to other parts of the world. In 2018, the median rate of deceased donor kidney transplants (DDKT) in Asia was significantly lower than the global median. To address this issue, an international team of researchers, including clinicians from Brunei and other Asian countries, has published a study in The Lancet Regional Health Southeast Asia. The study highlights the current state of DDKT policies and practices in Asia and proposes strategies to overcome existing challenges.
The researchers advocate for the establishment of a unified regional policy and support network to complement existing national policies, particularly in lower-income countries with inadequate governance in kidney transplantation activities. Without such policies, there is an increased risk of illegal commercialization of transplants and the exploitation of vulnerable populations. The success of DDKT programs in Asia relies heavily on robust local policies that strengthen infrastructure, involve the public, provide multi-sectorial support, and establish appropriate legislative frameworks. Due to the unique demographic, ethnic, cultural, and religious diversity of Asia, solutions borrowed directly from developed Western countries may not be suitable. Challenges such as varying population sizes, geographical disparities, income levels, health funding mechanisms, public awareness, and the risk of organ transplant commercialization further complicate the organ transplantation landscape in Asia.
The World Health Organization (WHO) emphasizes the need for global convergence in transplantation and urges countries to strive for self-sufficiency in transplantation, maximizing the therapeutic potential of DDKT programs. Developed nations with a strong donation culture have successfully increased DDKT rates through coordinated policies. The WHO’s regional strategy aims to enhance donation rates, education, infrastructure, international collaboration, and the ethical sustainability of DDKT. The findings of this study are crucial for shaping future policies and practices in kidney transplantation in Asia. The Borneo Bulletin, an English daily in Brunei, provides comprehensive coverage of these developments, serving as a valuable source of local, regional, and business news related to kidney transplantation in Asia.