Pediatric Versus Adult Kidney Transplant Activity in Arab Countries.

Abstract

This study aimed to evaluate current activities of pediatric versus adult kidney transplant in the Arab world. A questionnaire was mailed to all kidney transplant centers in Arab countries to collect the most recent data on kidney transplant activity. There were 3309 kidney transplants performed over a single year, with a transplant rate of 9.5 per million population; 298 of these were pediatric kidney transplant procedures, with a rate of 0.87 per million population, which is much lower than that shown in developed countries where it ranges from 5 to 10 per million population. Of all kidney transplants, the pediatric share is 9%, a rate that is twice as high as that shown among European children. Kidney transplant programs in most Arab countries rely exclusively on living donors, as there is a severe shortage of deceased donors. Of all transplants (that is, combined adult and pediatric), 93.5% were from living donors. Deceased donor pediatric kidney transplant is only available in the Kingdom of Saudi Arabia, Tunisia, and Kuwait. In these 3 Arab countries, which have stable deceased donor transplant programs, deceased donor transplant procedures ranged from 14% to 31% of all transplants. Of the 212 adult and pediatric transplant procedures that were performed from deceased donors in the 8 countries that perform deceased donor transplant, only 29 were for pediatric recipients. Surprisingly, the share of pediatric kidney transplant procedures was not better in the countries with higher overall kidney transplant rate or in those where deceased donor transplant was available. In general, pediatric kidney transplant procedures are still inactive in most Arab countries and mostly relies on living donors. The lack of well-developed deceased donor programs is the main issue to be addressed.