“…7 In New Zealand, Maori and Pacific Island recipients of deceased donor transplants have a 50% eight-year graft survival compared to 14 years for non-indigenous recipients, in part due to differences in mortality. 8 By contrast, despite a poor resource environment, Rizvi et al report one and five-year survival rates of 92 and 85%, respectively, among 2,249 living related kidney transplants in Pakistan, 9 whilst in Mexico, 90 and 80% one-year survival for living and deceased donor kidney transplants were reported among 1,356 transplants performed at a single centre. 10 However, while it is possible to achieve such excellent long-term results, most patients and their families in poor resource environments are not able to afford the high cost of immunosuppressant and antiviral medications needed to reduce the risk of graft loss and mortality.…”