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Rizvi SA, Naqvi SA, Zafar MN, et al. A kidney transplantation model in a low-resource country: an experience from Pakistan. Kidney Int Suppl (2011). 2013;3(2):236-240doi: 10.1038/kisup.2013.22.
Rizvi, S. A., Naqvi, S. A., Zafar, M. N., & Akhtar, S. F. (2013). A kidney transplantation model in a low-resource country: an experience from Pakistan. Kidney international supplements, 3(2), 236-240. https://doi.org/10.1038/kisup.2013.22
Rizvi, Syed Adibul Hasan, et al. "A kidney transplantation model in a low-resource country: an experience from Pakistan." Kidney international supplements vol. 3,2 (2013): 236-240. doi: https://doi.org/10.1038/kisup.2013.22
Rizvi SA, Naqvi SA, Zafar MN, Akhtar SF. A kidney transplantation model in a low-resource country: an experience from Pakistan. Kidney Int Suppl (2011). 2013 May;3(2):236-240. doi: 10.1038/kisup.2013.22. PMID: 25018989; PMCID: PMC4089647.
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Kidney Int Suppl (2011). 2013 May;3(2):236-240. doi: 10.1038/kisup.2013.22.

A kidney transplantation model in a low-resource country: an experience from Pakistan.

Kidney international supplements

Syed Adibul Hasan Rizvi, Syed Ali Anwar Naqvi, Mirza Naqi Zafar, Syed Fazal Akhtar

Affiliations

  1. Department of Urology and Transplant Surgery, Sindh Institute of Urology and Transplantation , Karachi, Pakistan.
  2. Department of Pathology, Sindh Institute of Urology and Transplantation , Karachi, Pakistan.
  3. Department of Nephrology, Sindh Institute of Urology and Transplantation , Karachi, Pakistan.

PMID: 25018989 PMCID: PMC4089647 DOI: 10.1038/kisup.2013.22

Abstract

Pakistan is a low-resource country with a population of 185 million where expenditure on health is 1.3% of the gross national product. The estimated incidence of end-stage renal disease (ESRD) is 100 per million of the population. The paucity and high costs of renal replacement therapy render more than 90% of the ESRD population disenfranchised from replacement therapy. Our center, which is a government sector organization, established as an integrated dialysis and living related renal transplant program in the 1980s, where all services were provided free of cost to all patients with life-long follow-up care including medications. The model was based on a concept of community/government partnership where the contributions to funds vary between 40% and 60% for each partner. The model has been self sustaining for 25 years, with an annual budget of $28 million in 2010. Presently, over 600 patients are dialyzed each day and each week, 7-10 patients have received live related transplants. The overall 1- and 5-year graft survival rate of 3150 transplants is 92% and 85%, respectively. Free dialysis and transplantation established our institute as a focus of transplantation in the country. This model therefore allowed the institute to have a vital role in the campaign against transplant tourism and in the promulgation of the transplant law. It shows that in low-resource countries, specialized centers in the government sector can, with community support, provide high-quality ESRD care to the disenfranchised population.

Keywords: developing country; model; transplant

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