Department of Kidney and Transplant Services, Division of Medicine, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia.
Nephrology and Hypertension Division, Department of Medicine, University of Cape Town, Cape Town, South Africa.
Nephrol Dial Transplant. 2024 Sep 5;39(Supplement_2):ii26-ii34. doi: 10.1093/ndt/gfae144.
Kidney transplantation (KT) is the preferred modality of kidney replacement therapy with better patient outcomes and quality of life compared with dialytic therapies. This study aims to evaluate the epidemiology, accessibility and availability of KT services in countries and regions around the world.
This study relied on data from an international survey of relevant stakeholders (clinicians, policymakers and patient advocates) from countries affiliated with the International Society of Nephrology that was conducted from July to September 2022. Survey questions related to the availability, access, donor type and cost of KT.
In total, 167 countries responded to the survey. KT services were available in 70% of all countries, including 86% of high-income countries, but only 21% of low-income countries. In 80% of countries, access to KT was greater in adults than in children. The median global prevalence of KT was 279.0 [interquartile range (IQR) 58.0-492.0] per million people (pmp) and the median global incidence was 12.2 (IQR 3.0-27.8) pmp. Pre-emptive KT remained exclusive to high- and upper-middle-income countries, and living donor KT was the only available modality for KT in low-income countries. The median cost of the first year of KT was $26 903 USD and varied 1000-fold between the most and least expensive countries.
The availability, access and affordability of KT services, especially in low-income countries, remain limited. There is an exigent need to identify strategies to ensure equitable access to KT services for people with kidney failure worldwide, especially in the low-income countries.
与透析疗法相比，肾移植（KT）是肾脏替代治疗的首选方式，能为患者带来更好的预后和生活质量。本研究旨在评估全球各国和地区的肾移植服务的流行病学、可及性和可用性。
本研究依赖于国际肾脏病学会附属国家相关利益攸关方（临床医生、政策制定者和患者权益倡导者）的国际调查数据，该调查于 2022 年 7 月至 9 月进行。调查问题涉及 KT 的可用性、可及性、供体类型和成本。
共有 167 个国家对调查做出了回应。70%的国家都提供了 KT 服务，其中包括 86%的高收入国家，但仅有 21%的低收入国家提供该服务。在 80%的国家中，成人获得 KT 的机会大于儿童。全球 KT 的中位数流行率为 279.0 [四分位距（IQR）58.0-492.0]每百万人（pmp），全球 KT 的中位数发病率为 12.2 [IQR 3.0-27.8] pmp。抢先 KT 仍然仅限于高收入和中高收入国家，而在低收入国家，活体供者 KT 是唯一可获得的 KT 方式。KT 第一年的中位数费用为 26903 美元，在费用最高和最低的国家之间相差 1000 倍。
KT 服务的可及性、可及性和可负担性，特别是在低收入国家，仍然有限。迫切需要确定策略，确保全球范围内肾衰竭患者，特别是在低收入国家，公平获得 KT 服务。
