Ten-year review of renal transplants in Punjab Province, Pakistan.

Background: The Punjab Human Organ Transplantation Authority was established in 2012 as a provincial regulatory entity responsible for providing oversight for human organ transplants. However, little is known about the capacity of the province to deliver kidney transplant services.

Aim: To review kidney transplant services in Punjab, Pakistan, from January 2014 to December 2023.

Methods: This retrospective, cross-sectional study analysed secondary data on kidney transplants from 41 hospitals in Punjab Province, Pakistan. It examined the availability and accessibility of transplant services, the distribution of centres, and number and types of transplants.

Results: Only 8 of the 28 districts in the province had kidney transplant centres. Most (75%) of these centres were located in Lahore and Rawalpindi and belonged mostly to the private sector. The average number of transplant centres per million population varied widely, from 0.13 in Sahiwal to 1.13 in Lahore. The average coverage was 0.37 per million population. During the 10-year period, the centres performed 3627 kidney transplants, with an average of 362 transplants per year. Kidney transplant was not included in insurance coverage.

Conclusions: The variations in availability and use of kidney transplant services in Punjab Province may be due to the lack of essential infrastructure and equipment, lack of trained transplant health workforce and inadequate funding. There is a dire need to improve renal transplant facilities and services and encourage organ donation in the province, including in the public sector.