EXPERIMENTAL AND CLINICAL TRANSPLANTATION

Key words : Equity, Innovation, Renal transplant, Saudi Center for Organ Transplantation

The Kingdom of Saudi Arabia has witnessed significant advancements in the field of transplantation, particularly concerning pediatric kidney donation and transplantation.¹ In the initial stages, spanning from 1948 to 1979, the landscape of kidney transplantation within the Kingdom was sparse, with most patients seeking treatment abroad due to the absence of a national registry or dialysis facilities for transplantation. However, concerted efforts and strategic interventions have propelled Saudi Arabia to the forefront of transplantation, marked by notable achievements such as ranking fourth globally for living-related kidney transplant and liver transplant.² This progress can be attributed to initiatives such as the establishment of the national kidney foundation in 1984, religious agreements endorsing transplantation within Islamic tenets, and pivotal decisions by regulatory bodies, like the Senior Chief Commission in 1999.³ Moreover, Saudi Arabia’s commitment to ethical transplant practices is underscored by its alignment with international frameworks such as the Istanbul Declaration aimed at combating organ trafficking and commercialism.^4,5 This article delineates the evolution of pediatric kidney donation and transplantation within the Kingdom of Saudi Arabia, examining its institutional framework, allocation strategies, and recent trends.

Since its inception in 1985, the Saudi Center for Organ Transplantation (SCOT) has endeavored to achieve self-sufficiency in transplantation, marked by a transition from reliance on foreign expertise to indigenous capabilities. The establishment of a national kidney foundation in 1984 laid the groundwork for subsequent advancements, culminating in the initiation of a deceased organ donation program in 1986 and the elevation of the foundation to SCOT in 1993.⁶ Key operational mechanisms, including legal frameworks, donor quality assurance protocols, and public awareness campaigns, have been instrumental in facilitating organ procurement and transplantation. Notably, the stewardship of SCOT has ensured adherence to ethical norms and operational efficiency, exemplified by the organization’s pioneering brain death documentation system and its expanding influence across the Gulf region.

Pediatric kidney transplantation in Saudi Arabia is governed by a rigorous allocation program aimed at ensuring equitable access to organs while optimizing transplant outcomes. Allocation criteria encompass demographic considerations, donor compatibility, and risk assessments, with pediatric recipients accorded priority status to address their unique medical needs. The allocation strategies of SCOT, underpinned by a comprehensive scoring system and emphasis on urgency, reflect a commitment to patient-centered care and resource optimization, with particular focus to prioritize pediatric allocation when medically appropriate.⁷ The organization’s proactive approach extends beyond kidney transplant to encompass liver, heart, and lung transplant, with meticulous attention to donor demographics and logistical considerations, ensuring the integrity and safety of transplant procedures.

Recent trends indicate a growing reliance on both deceased and living donors for pediatric kidney transplantation in Saudi Arabia. In 2022, SCOT recorded 14 cases from deceased donors and 65 cases from living donors, underscoring the expanding pool of available organs and the efficacy of transplant programs.⁸ Moreover, SCOT’s emphasis on regulatory oversight and quality assurance measures has engendered public trust and confidence in the transplant process, mitigating concerns regarding unethical practices and ensuring equitable access to transplant services across the Kingdom.

The evolution of pediatric kidney donation and transplantation in the Kingdom of Saudi Arabia underscores the transformative effects of strategic initiatives and institutional reforms aimed at fostering self-sufficiency and ethical stewardship in transplantation. The ascendance of SCOT as a regional hub for organ procurement and transplantation is a testament to Saudi Arabia’s commitment to advancing health care delivery and promoting international collaboration in combating organ trafficking and commercialism. Moving forward, sustained investments in infrastructure, capacity building, and regulatory oversight will be paramount to addressing emerging challenges and consolidating Saudi Arabia’s position as a global leader in transplantation. By prioritizing patient welfare, ethical principles, and operational excellence, Saudi Arabia is poised to shape the future trajectory of pediatric kidney transplantation and usher in a new era of health care innovation and equity within the region and beyond.

Volume: 22 Issue: 10 October 2024 - Supplement - 5

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