Barriers to Kidney Transplantation among Adults on Maintenance Dialysis in Western Region Saudi Arabia: A Cross-Sectional Study

Alobaidi, Sami; Dwid, Naji; Salem, Nada; Mehdawi, Fahtima; Kashgary, Abdullah; Alhozali, Hanadi; Nablawi, Rana; Alsolami, Enad; Shaheen, Faissal A M; Akl, Ahmed

doi:10.4103/1319-2442.318548

Cited by 4 publications

(3 citation statements)

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“…This supports our hypothesis that the lack of available donors was the main driver for those patients to seek kidney transplantation overseas. A recent survey showed that the availability of donors is the most common barrier to kidney transplantation [ 20 ]. Living-related donors were the main source of kidney grafts as per our local experience.…”

Section: Discussionmentioning

confidence: 99%

“…A local survey revealed that only 56% of patients on dialysis were referred for pre-transplant evaluation and 29% were on the active transplant list [ 20 ]. It is possible that patients who traveled overseas for transplants were not referred to their local transplant program in a timely manner which has driven them to seek transplants overseas.…”

Section: Discussionmentioning

confidence: 99%

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A Three-Year Experience With Overseas Kidney Transplantation in a Tertiary Transplant Center in Saudi Arabia

Tawhari¹,

Radwi²

2022

Cureus

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Background Overseas kidney transplantation is known to be associated with adverse outcomes. In this study, we aim to present a detailed analysis of our three years of experience with overseas kidney transplantation at one of the largest kidney transplant referral sites in the Kingdom of Saudi Arabia. Materials and methods A retrospective cohort study included patients who underwent kidney transplantation overseas and were subsequently followed up at King Abdulaziz Medical City from January 2016 to July 31, 2019. In addition, we compared the outcomes of the patients who underwent kidney transplantation overseas with a cohort of patients who were transplanted locally within the same period. Patients in both cohorts had to have at least one year of follow-up post-transplantation. Results We included a total of 51 patients who underwent kidney transplantation overseas. The mean age of the cohort was 44.7 years, and 69% were male. Almost 60% of the cohort had one or no comorbidity prior to transplant, with hypertension (84%) and diabetes mellitus (37%) being the leading comorbidities. The cause of end-stage kidney disease was unknown in 55% of our patients. In those who had an identifiable cause, lupus nephropathy and diabetes were the most common causes of kidney failure. In comparison with the locally transplanted cohort, no difference was detected between these groups in their baseline characteristics, type or number of comorbidities, medical or surgical complications postoperatively, and one-year mortality. However, we found that the graft rejection rate was significantly higher in patients transplanted overseas (OR=5.4, p<0.001). In addition, the proportion of patients who received anti-thymocyte globulin (ATG) induction was also less in the group with overseas kidney transplantation (58% vs. 22%, p<0.001). Conclusion Overseas transplantation is associated with an increased risk for graft rejection. Our study suggests that overseas kidney transplantation is possibly driven by a lack of donors, especially cadaveric. Counseling patients about risks associated with overseas kidney transplantation and encouraging the public to register for organ donation after death may help curb out this practice.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

A Three-Year Experience With Overseas Kidney Transplantation in a Tertiary Transplant Center in Saudi Arabia

Tawhari¹,

Radwi²

2022

Cureus

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“…The most common reasons patients reported for remaining on dialysis included: doing well on dialysis, knowing other patients with failed kidney transplantation, 16 the waiting process, concerns about the social and economic impact of transplantation 17 and surgical complications. 18 However, refusal of kidney transplantation by patients undergoing dialysis, especially PD, has not been well investigated especially in Middle Eastern countries, such as Iran. So, the aim of this study was to describe the reasons given by Iranian PD patients for refusing kidney transplantation.…”

Section: Introductionmentioning

confidence: 99%

Reasons for kidney transplant refusal among patients receiving peritoneal dialysis: A qualitative study

et al. 2023

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Background: Even though kidney transplantation has better outcomes compared to dialysis therapies, some patients undergoing peritoneal dialysis (PD) refuse to consider kidney transplantation. Identification of the underlying reason for patient refusal may improve patients’ acceptance of kidney transplantation. Aim: The aim of this study was to describe the reasons given by Iranian PD patients for refusing kidney transplantation. Method: Eighteen patients undergoing PD participated. Data were collected using semi-structured interviews and were analysed using conventional qualitative content analysis. Results: The analysis leads to the emergence of two categories and six subcategories: negative outcomes of kidney transplantation (financial burden, psychosocial problems and physical complications) and doubtful factors for kidney transplantation (negative attitudes towards kidney transplantation, long waiting time for kidney transplantation and compatibility of PD with daily life). The financial burden and long waiting time for kidney transplantation were the most important factors in the reluctance of kidney transplantation by PD patients. Implication for practice: Patients undergoing PD declined kidney transplantation for several reasons, such as financial burden, fear of post-transplantation side effects, long waiting time for kidney transplantation. Reducing the time of kidney transplantation and insurance coverage of transplant costs can change the attitude of PD patients towards transplant.

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Factors Affecting On Dialysis Patients to Choose or Refuse Kidney Transplantation as Renal Replacement Therapy

Ali

Wifaq

Alam

et al. 2023

PJHS

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Kidney transplantation (KT) is the most successful treatment for end-stage renal disease patients. But objective data about patients' willingness to undergo kidney transplant is still lacking in Pakistan. Objective: To assess barriers to KT and identify factors which could influence the willingness regarding KT among hemodialysis dependent patients. Methods: This cross-sectional study carried out at Dialysis Unit, Dept. of Urology and Kidney transplantation Lahore General Hospital, Lahore on 100 hemodialysis dependent patients by completion of structured questionnaire about their knowledge and attitudes toward KT and how satisfied they were with dialysis. Results: The mean age of the patients was 42.8 ± 10.6 years with 55% male and 45% female patients. The percentage of patients who were willing to get a kidney transplant was 60%. The main reason of unwillingness to undergo KT was lack of donor (83.3%). Motivating factors in patients to choose KT were vascular access constraints 75%, studies or work difficulties 70%, fluid and dietary restrictions account for 63.3%. The percentage of patients who wanted a deceased kidney for transplant was 50%, whereas the percentage of patients who preferred a living kidney for transplant was 25% (17 % relatives and 8% non-relatives) and 25% of patients had no preference. Conclusion: Willingness to get kidney transplant is relatively low in Pakistan. Lack of donor, fear of surgery and financial problems are the main barriers for KT in ESRD patient

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Barriers to Kidney Transplantation among Adults on Maintenance Dialysis in Western Region Saudi Arabia: A Cross-Sectional Study

Cited by 4 publications

References 0 publications

A Three-Year Experience With Overseas Kidney Transplantation in a Tertiary Transplant Center in Saudi Arabia

A Three-Year Experience With Overseas Kidney Transplantation in a Tertiary Transplant Center in Saudi Arabia

Reasons for kidney transplant refusal among patients receiving peritoneal dialysis: A qualitative study

Factors Affecting On Dialysis Patients to Choose or Refuse Kidney Transplantation as Renal Replacement Therapy

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