Department of Urology, Sindh Institute of Urology and Transplantation, Civil Hospital, Karachi, Pakistan.
Am J Transplant. 2011 Nov;11(11):2302-7. doi: 10.1111/j.1600-6143.2011.03712.x. Epub 2011 Aug 22.
The estimated incidence of end-stage renal disease (ESRD) in Pakistan is 100 per million population. Paucity and high costs of renal replacement therapy allows only 10% to get dialysis and 4-5% transplants. Our center, a government organization, started a dialysis and transplant program in 1980s where all services were provided free of charge to all patients. It was based on the concept of community government partnership funded by both partners. The guiding principles were equity, transparency, accountability and development of all facilities under one roof. This partnership has sustained itself for 30 years with an annual budget of $25 million in 2009. Daily 600 patients are dialyzed and weekly 10-12 receive transplants. One- and 5-year graft survival of 3000 transplants is 92% and 85%, respectively. The institute became a focus of transplantation in Pakistan and played a vital role in the campaign against transplant tourism and in promulgation of transplant law of 2007, and also helped to increase altruistic transplants in the country. This model emphasizes that in developing countries specialized centers in government sector are necessary for transplantation to progress and community support can make it available to the common man.
巴基斯坦估计终末期肾病（ESRD）的发病率为每百万人口 100 人。肾脏替代治疗的缺乏和高昂的成本使得只有 10%的患者能够接受透析，4-5%的患者能够接受移植。我们的中心是一个政府组织，于 20 世纪 80 年代启动了透析和移植项目，所有服务均免费向所有患者提供。该项目基于社区-政府合作伙伴关系的理念，由双方共同资助。指导原则是公平、透明、问责制以及在一个屋檐下发展所有设施。这种伙伴关系已经持续了 30 年，2009 年的年度预算为 2500 万美元。目前，每天有 600 名患者接受透析，每周有 10-12 名患者接受移植。3000 例移植的 1 年和 5 年移植物存活率分别为 92%和 85%。该研究所成为巴基斯坦移植的焦点，在反对移植旅游和颁布 2007 年移植法方面发挥了重要作用，还有助于增加该国的无私移植。这种模式强调，在发展中国家，政府部门的专门中心对于移植的发展是必要的，而社区的支持可以使普通人也能获得这种治疗。
