Korean J Transplant.  2022 Nov;36(Supple 1):S78. 10.4285/ATW2022.F-1964.

Transplantation status, challenges and outlook: Bangladesh perspective

• Rashid HU
• Salma Begum NA
• Uz-Zaman Arefin MS
• Nomany S
• Nobi F
• Sayed A
• Rubel RA
• Alam AKMK

• KMID: 2535594
• DOI: http://doi.org/10.4285/ATW2022.F-1964

Abstract

In Bangladesh, the first living donor kidney transplantation was performed in 1982. Since then above 2,300 kidney transplanta-tions were performed. Liver transplantation was started in 2010, but only six were performed. Cornea transplantation was started in 1984 and over 5,500 were done. Bone marrow transplantation was started in 2014 and 25 were transplanted. About 10 centers are performing kidney and three centers performing liver transplantation. In 2018, ABO-incompatible kidney transplantation was started and seven cases performed. Each year, nearly 40,000 patients reach end-stage renal disease (ESRD) but only 250–300 get transplanted. The graft survival at 1-, 5-, and 10- year is 96%, 85%, 50% respectively. Challenges in living donor transplantation include (a) scarcity of donors due to lack of awareness and fear of donation; (b) high cost of investigations, surgery and immunosuppressive drugs with meagre Government subsidy makes transplantation unaffordable for many patients; (c) lack of trained transplant physicians, surgeons, nurses, (d) lack of necessary laboratory facilities. Hurdles for deceased donor transplantation are (a) lack of ICU infrastructure for identification, declaration and management of brain death donors; (b) lack of awareness among general people and health care professionals; (c) certain socio-cultural and religious beliefs; (d) lack of trained transplant physicians, surgeons, nurses, transplant coordinators and grief counselors. In Bangladesh, only living donor transplants were performed so far. Efforts as now being made to start deceased donor transplantation. To increase awareness, different programs and conferences involving healthcare professionals, public, Islamic scholars and international advisers were organized. Leaflets, posters, donor cards were made. Brain Death Committee and Organ Procurement Committee are established and train-ing programs for transplant coordinators and grief counsellors have been organized. It is expected that in future deceased donor transplantation will take place and facility for living donor transplantation will expand.