Deceased Donor Kidney Transplantation in Pakistan: An Underutilized Resource
DOI:
https://doi.org/10.52206/jsmc.2026.16.2.1461Abstract
Pakistan has more than 241 million people [1]. But there isn’t a complete registry to show how many have chronic kidney disease (CKD). In 2024, only 28 centers shared their data, so the actual number of cases is probably higher [2]. Some studies estimate that about 24% to 25% of Pakistanis have CKD [3,4]. Based on these estimates, around 58-61 million Pakistanis have CKD. Treating CKD is very costly. Given the fragile economy, this is a major public health problem. Most people can’t get hemodialysis or peritoneal dialysis. Kidney transplants usually help people with CKD to live longer. Sporadic live kidney transplantation does happen in Pakistan. On the contrary, organ donation after death doesn’t happen much in Pakistan. As a result, deceased kidney transplantation is negligible in the country.
Pakistan puts just about 1% of its GDP into health care [5]. That means treatments like dialysis aren’t fully covered, and patients usually have to pay the costs themselves. Most big hospitals only do dialysis for emergencies. Very few centers provide long-term maintenance dialysis. In 2024–2025, the average person made around $1,824, but a year of dialysis can cost $13,510 [6,7]. Around 61% of people live in rural areas, where dialysis is even harder to access [8]. Even when people can get it, it’s rarely free.
Kidney transplants help people live longer and can really improve their quality of life [8,9]. The initial cost of transplant is high, but over time, it is lower than that of regular dialysis [10]. The first kidney transplant in Pakistan happened back in 1979, and since then, transplants from living donors have continued [11]. But it’s still very rare to get a kidney from a deceased donor. Kidneys donated after brain death (DBD) or donation after cardiac death (DCD) provide better survival than dialysis [12]. DBD is common in many countries, and DCD is also used in several places [13]. Due to advancements in pharmacotherapy and perfusion techniques, donated organs from deceased donors last longer than before [14]. For example, in the United States, a kidney from a deceased donor now lasts about 12 years, compared to just 8 years in the 1990s [15].
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