. 2022 Jun 1;106(6):1113-1122.

doi: 10.1097/TP.0000000000003943. Epub 2022 Sep 7.

Global Estimates of Capacity for Kidney Transplantation in World Countries and Regions

Dominic Mudiayi¹, Soroush Shojai¹, Ikechi Okpechi^{1

2}, Emily A Christie¹, Kevin Wen¹, Mostafa Kamaleldin¹, Mohamed Elsadig Osman¹, Meaghan Lunney³, Bhanu Prasad⁴, Mohamed A Osman¹, Feng Ye¹, Maryam Khan¹, Htay Htay⁵, Fergus Caskey^{6

7

8}, Kailash K Jindal¹, Scott Klarenback¹, Vivekanand Jha^{9

10

11}, Eric Rondeau^{12

13}, Rumeyza Turan Kazancioglu¹⁴, Shahrzad Ossareh¹⁵, Kitty J Jager¹⁶, Csaba P Kovesdy¹⁷, Philip J O'Connell^{18

19}, Elmi Muller²⁰, Timothy Olanrewaju²¹, John S Gill²², Marcello Tonelli^{23

24}, David C Harris²⁵, Adeera Levin²², David W Johnson^{26

27

28}, Aminu K Bello¹

Affiliations

¹ Division of Nephrology and Immunology, Department of Medicine, University of Alberta, Edmonton, AB, Canada.
² Division of Nephrology and Hypertension, University of Cape Town, Cape Town, South Africa.
³ Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada.
⁴ Section of Nephrology, Department of Medicine, Regina General Hospital, Regina, SK, Canada.
⁵ Department of Renal Medicine, Singapore General Hospital, Singapore, Singapore.
⁶ UK Renal Registry, Learning and Research, Southmead Hospital, Bristol, United Kingdom.
⁷ Population Health Sciences, University of Bristol, Bristol, United Kingdom.
⁸ The Richard Bright Renal Unit, Southmead Hospital, North Bristol NHS Trust, Bristol, United Kingdom.
⁹ George Institute for Global Health, UNSW, New Delhi, India.
¹⁰ School of Public Health, Imperial College London, London, United Kingdom.
¹¹ Department of Medicine, Manipal Academy of Higher Education, Manipal, India.
¹² Intensive Care Nephrology and Transplantation Department, Hôpital Tenon, Assistance Publique-Hôpitaux de Paris, Paris, France.
¹³ Faculty of Medicine, Sorbonne Université, Paris, France.
¹⁴ Division of Nephrology, Bezmialem Vakif University, Istanbul, Turkey.
¹⁵ Section of Nephrology and Hemodialysis, Hasheminejad Kidney Center, Iran University of Medical Sciences, Tehran, Iran.
¹⁶ ERA-EDTA Registry, Department of Medical Informatics, Academic Medical Center, Amsterdam Public Health Research Institute, University of Amsterdam, Amsterdam, The Netherlands.
¹⁷ Department of Medicine, University of Tennessee Health Science Center, Memphis, TN.
¹⁸ Renal Unit, Westmead Clinical School, University of Sydney at Westmead Hospital, Sydney, NSW, Australia.
¹⁹ The Westmead Institute for Medical Research, Westmead, NSW, Australia.
²⁰ Division of General Surgery, Department of Surgery, University of Cape Town, Cape Town, South Africa.
²¹ Department of Medicine, University of Ilorin, Ilorin, Nigeria.
²² Division of Nephrology, Department of Medicine, University of British Columbia, Vancouver, BC, Canada.
²³ Department of Medicine, University of Calgary, Calgary, AB, Canada.
²⁴ Pan-American Health Organization/World Health Organization's Collaborating Centre in Prevention and Control of Chronic Kidney Disease, University of Calgary, Calgary, AB, Canada.
²⁵ Centre for Transplantation and Renal Research, Westmead Institute for Medical Research, University of Sydney, Sydney, NSW, Australia.
²⁶ Department of Nephrology, Metro South Integrated Nephrology and Transplant Services, Princess Alexandra Hospital, Brisbane, QLD, Australia.
²⁷ Centre for Kidney Disease Research, University of Queensland at Princess Alexandra Hospital, Brisbane, QLD, Australia.
²⁸ Translational Research Institute, Brisbane, QLD, Australia.

PMID: 34495014
PMCID: PMC9128615
DOI: 10.1097/TP.0000000000003943

Global Estimates of Capacity for Kidney Transplantation in World Countries and Regions

Dominic Mudiayi et al. Transplantation. 2022.

. 2022 Jun 1;106(6):1113-1122.

doi: 10.1097/TP.0000000000003943. Epub 2022 Sep 7.

Authors

Affiliations

¹ Division of Nephrology and Immunology, Department of Medicine, University of Alberta, Edmonton, AB, Canada.
² Division of Nephrology and Hypertension, University of Cape Town, Cape Town, South Africa.
³ Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada.
⁴ Section of Nephrology, Department of Medicine, Regina General Hospital, Regina, SK, Canada.
⁵ Department of Renal Medicine, Singapore General Hospital, Singapore, Singapore.
⁶ UK Renal Registry, Learning and Research, Southmead Hospital, Bristol, United Kingdom.
⁷ Population Health Sciences, University of Bristol, Bristol, United Kingdom.
⁸ The Richard Bright Renal Unit, Southmead Hospital, North Bristol NHS Trust, Bristol, United Kingdom.
⁹ George Institute for Global Health, UNSW, New Delhi, India.
¹⁰ School of Public Health, Imperial College London, London, United Kingdom.
¹¹ Department of Medicine, Manipal Academy of Higher Education, Manipal, India.
¹² Intensive Care Nephrology and Transplantation Department, Hôpital Tenon, Assistance Publique-Hôpitaux de Paris, Paris, France.
¹³ Faculty of Medicine, Sorbonne Université, Paris, France.
¹⁴ Division of Nephrology, Bezmialem Vakif University, Istanbul, Turkey.
¹⁵ Section of Nephrology and Hemodialysis, Hasheminejad Kidney Center, Iran University of Medical Sciences, Tehran, Iran.
¹⁶ ERA-EDTA Registry, Department of Medical Informatics, Academic Medical Center, Amsterdam Public Health Research Institute, University of Amsterdam, Amsterdam, The Netherlands.
¹⁷ Department of Medicine, University of Tennessee Health Science Center, Memphis, TN.
¹⁸ Renal Unit, Westmead Clinical School, University of Sydney at Westmead Hospital, Sydney, NSW, Australia.
¹⁹ The Westmead Institute for Medical Research, Westmead, NSW, Australia.
²⁰ Division of General Surgery, Department of Surgery, University of Cape Town, Cape Town, South Africa.
²¹ Department of Medicine, University of Ilorin, Ilorin, Nigeria.
²² Division of Nephrology, Department of Medicine, University of British Columbia, Vancouver, BC, Canada.
²³ Department of Medicine, University of Calgary, Calgary, AB, Canada.
²⁴ Pan-American Health Organization/World Health Organization's Collaborating Centre in Prevention and Control of Chronic Kidney Disease, University of Calgary, Calgary, AB, Canada.
²⁵ Centre for Transplantation and Renal Research, Westmead Institute for Medical Research, University of Sydney, Sydney, NSW, Australia.
²⁶ Department of Nephrology, Metro South Integrated Nephrology and Transplant Services, Princess Alexandra Hospital, Brisbane, QLD, Australia.
²⁷ Centre for Kidney Disease Research, University of Queensland at Princess Alexandra Hospital, Brisbane, QLD, Australia.
²⁸ Translational Research Institute, Brisbane, QLD, Australia.

PMID: 34495014
PMCID: PMC9128615
DOI: 10.1097/TP.0000000000003943

Abstract

Background: Kidney transplantation (KT) is the optimal treatment for kidney failure and is associated with better quality of life and survival relative to dialysis. However, knowledge of the current capacity of countries to deliver KT is limited. This study reports on findings from the 2018 International Society of Nephrology Global Kidney Health Atlas survey, specifically addressing the availability, accessibility, and quality of KT across countries and regions.

Methods: Data were collected from published online sources, and a survey was administered online to key stakeholders. All country-level data were analyzed by International Society of Nephrology region and World Bank income classification.

Results: Data were collected via a survey in 182 countries, of which 155 answered questions pertaining to KT. Of these, 74% stated that KT was available, with a median incidence of 14 per million population (range: 0.04-70) and median prevalence of 255 per million population (range: 3-693). Accessibility of KT varied widely; even within high-income countries, it was disproportionately lower for ethnic minorities. Universal health coverage of all KT treatment costs was available in 31%, and 57% had a KT registry.

Conclusions: There are substantial variations in KT incidence, prevalence, availability, accessibility, and quality worldwide, with the lowest rates evident in low- and lower-middle income countries. Understanding these disparities will inform efforts to increase awareness and the adoption of practices that will ensure high-quality KT care is provided around the world.

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Conflict of interest statement

D.W.J. has received consultancy fees, research grants, speaker’s honoraria, and travel sponsorships from Baxter Healthcare and Fresenius Medical Care; consultancy fees from Astra Zeneca and AWAK, speaker’s honoraria and travel sponsorships from ONO; and travel sponsorships from Amgen. He is a current recipient of an Australian National Health and Medical Research Council Leadership Investigator Grant. V.J. has received grants, speaker honoraria, or consultancy fees from GlaxoSmithKline, Biocon, Baxter, Janssen, Medtronic, and NephroPlus. He has a policy of all funds being paid to his employer. A.K.B. has received consultancy fees from Janssen. The International Society of Nephrology provided administrative support for the design and implementation of the study and data collection activities. The authors were responsible for data management, analysis, and interpretation, as well as article preparation, review, and approval and the decision to submit the article for publication. The remaining authors have no conflicts of interest to declare.

Figures

**FIGURE 1.**
Global incidence of kidney transplantation. pmp, per million population.

**FIGURE 2.**
Global prevalence of kidney transplantation. pmp, per million population.

**FIGURE 3.**
Incidence of kidney transplantation by country gross domestic product. AFG, Afghanistan; ALB, Albania; ARE, United Arab Emirates; ARG, Argentina; ARM, Armenia; AUS, Australia; AUT, Austria; BEL, Belgium; BGR, Bulgaria; BIH, Bosnia and Herzegovina; BLR, Belarus; BOL, Bolivia; BRA, Brazil; BTN, Bhutan; CAN, Canada; CHE, Switzerland; CHL, Chile; CHN, China; COL, Colombia; CRI, Costa Rica; CUB, Cuba; CYP, Cyprus; CZE, Czech Republic; DEU, Germany; DNK, Denmark; DOM, Dominican Republic; DZA, Algeria; ECU, Ecuador; EGY, Egypt; ESP, Spain; EST, Estonia; FIN, Finland; FRA, France; GBR, United Kingdom; GEO, Georgia; GRC, Greece; GTM, Guatemala; HND, Honduras; HRV, Croatia; HUN, Hungary; IDN, Indonesia; IND, India; IRL, Ireland; IRN, Iran; ISL, Iceland; ISR, Israel; ITA, Italy; JOR, Jordan; JPN, Japan; KAZ, Kazakhstan; KEN, Kenya; KWT, Kuwait; LBN, Lebanon; LKA, Sri Lanka; LTU, Lithuania; LUX, Luxembourg; LVA, Latvia; MAR, Morocco; MEX, Mexico; MLT, Malta; MMR, Myanmar; MNG, Mongolia; MYS, Malaysia; NGA, Nigeria; NIC, Nicaragua; NLD, Netherlands; NOR, Norway; NPL, Nepal; NZL, New Zealand; OMN, Oman; PAK, Pakistan; PAN, Panama; PER, Peru; PHL, Philippines; PMP, per million population; POL, Poland; PPP, purchasing power parity; PRT, Portugal; PRY, Paraguay; QAT, Qatar; ROU, Romania; RUS, Russian Federation; SAU, Saudi Arabia; SDN, Sudan; SGP, Singapore; SLV, El Salvador; SRB, Serbia; SVK, Slovak Republic; SVN, Slovenia; SWE, Sweden; SYR, Syrian Arab Republic; THA, Thailand; TJK, Tajikistan; TUN, Tunisia; TUR, Turkey; UKR, Ukraine; URY, Uruguay; USA, United States; VEN, Venezuela; VNM, Vietnam; ZAF, South Africa.

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References

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Global Estimates of Capacity for Kidney Transplantation in World Countries and Regions

Affiliations

Global Estimates of Capacity for Kidney Transplantation in World Countries and Regions

Authors

Affiliations

Abstract

Conflict of interest statement

Figures

References

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LinkOut - more resources

Full Text Sources

Medical