Living related renal transplants with lifelong follow-up. A model for the developing world.
OBJECTIVE
To describe the dynamic of a model of public government partnership for dialysis and transplantation in developing countries.


METHODS
A model was established on the philosophy of public-government partnership to provide an integrated dialysis and transplant service "Free with dignity" with lifelong follow-up care and medications. The government provided 50% of funds and the public was motivated to donate the rest. This included affluent individuals, corporations, business houses and the general public.


RESULTS
This model has been sustained for the last two decades. In 2008, 655,000 patients were treated at SIUT. Over 600 patients are dialyzed each day with a total of 165,411 dialysis sessions/year. Thus far 2,249 transplants have been performed, 431 in 2008. One- and 5-year graft survival rates were 92% and 85%, respectively. The laboratory performed 4.1 million tests and radiological investigations numbered 164,217. Over $ 6 million were spent on medications. Free services offered by the model have motivated the government to increase its funding from $ 2.1 million in 1998 to $ 10 million in 2008 and the public has matched these figures with total donations exceeding $ 20 million.


CONCLUSIONS
For transplantation to be successful in developing countries, it has to be made available to the common people who constitute 90% of the population. Our model of public-government partnership has made dialysis and transplantation available to the disenfranchised with lifelong follow-up and medications. Transplantation has become relevant to them, resulting in societal acceptance of transplantation as a preferred mode of therapy. This has motivated society to support both living related and deceased donor programs.
Rizvi
S A H
SA
Sindh Institute of Urology and Transplantation (SIUT), Karachi, Pakistan. arizvi@siut.org
Naqvi
S A A
SA
Zafar
M N
MN
Hussain
Z
Z
Hashmi
A
A
Hussain
M
M
Akhtar
F
F
Ahmed
E
E
D017046:Cost Savings; D003906:Developing Countries; D005380:Financing, Government; D005381:Financing, Organized; D005500:Follow-Up Studies; D006801:Humans; D007165:Immunosuppression Therapy / Q000191:economics; D016030:Kidney Transplantation / Q000191:economics*; D019520:Living Donors; D017146:Models, Organizational; D010154:Pakistan; D006435:Renal Dialysis / Q000191:economics