Living related renal transplants with lifelong follow-up. A model for the developing world

Clin Nephrol. 2010 Nov:74 Suppl 1:S142-9. doi: 10.5414/cnp74s142.

Abstract

Aims: To describe the dynamic of a model of public government partnership for dialysis and transplantation in developing countries.

Materials: A model was established on the philosophy of public-government partnership to provide an integrated dialysis and transplant service "Free with dignity" with lifelong follow-up care and medications. The government provided 50% of funds and the public was motivated to donate the rest. This included affluent individuals, corporations, business houses and the general public.

Results: This model has been sustained for the last two decades. In 2008, 655,000 patients were treated at SIUT. Over 600 patients are dialyzed each day with a total of 165,411 dialysis sessions/year. Thus far 2,249 transplants have been performed, 431 in 2008. One- and 5-year graft survival rates were 92% and 85%, respectively. The laboratory performed 4.1 million tests and radiological investigations numbered 164,217. Over $ 6 million were spent on medications. Free services offered by the model have motivated the government to increase its funding from $ 2.1 million in 1998 to $ 10 million in 2008 and the public has matched these figures with total donations exceeding $ 20 million.

Conclusions: For transplantation to be successful in developing countries, it has to be made available to the common people who constitute 90% of the population. Our model of public-government partnership has made dialysis and transplantation available to the disenfranchised with lifelong follow-up and medications. Transplantation has become relevant to them, resulting in societal acceptance of transplantation as a preferred mode of therapy. This has motivated society to support both living related and deceased donor programs.

MeSH terms

  • Cost Savings
  • Developing Countries
  • Financing, Government
  • Financing, Organized
  • Follow-Up Studies
  • Humans
  • Immunosuppression Therapy / economics
  • Kidney Transplantation / economics*
  • Living Donors*
  • Models, Organizational
  • Pakistan
  • Renal Dialysis / economics