Lack of organ donation awareness keeps most kidney patients on dialysis

PESHAWAR: Limited public awareness about organ donation is leaving most patients with both damaged kidneys dependent on repeated dialysis, with health experts saying only one per cent receive renal transplants.

Dr Samiur Rahman, a renal transplant surgeon at the Institute of Kidney Diseases (IKD) at Hayatabad Medical Complex, said dialysis was not a permanent answer for such patients and that transplantation offered a better long-term outcome when medically possible. He told Dawn that many patients die while waiting for a transplant, largely because organ donation has not taken root as a social practice in Pakistan.

Attributing the problem to the absence of a strong deceased donor system, Dr Sami said such a programme was the only viable path to reduce lifelong dependence on dialysis for many patients. He added that the IKD transplant unit, which he heads, is currently performing two transplants a day and could raise that number if more kidneys were donated.

He also said organs including kidneys, lungs, liver and heart from deceased donors could help save the lives of terminally ill patients and called for wider public education on the issue.

In his remarks, Dr Sami said kidney transplantation is generally the preferred long-term treatment when a patient is medically fit and a suitable donor is available, while dialysis usually serves as a supportive or bridging treatment.

"Dialysis is a temporary and time-consuming solution. It needs travelling to hospitals to undergo long sessions while renal transplants ensure better quality of life, freedom from machines and is a long-term solution,"

A health department report said 966,466 dialysis sessions have been carried out since 2016 under the Sehat Card Plus initiative. 28,657 patients with kidney failure require dialysis every month, fortnight or week to remain alive.

The report gave an age-wise breakdown of these patients: 300 were between one and 10 years old, 1,291 between 11 and 20, 1,365 between 20 and 30, 3,682 between 30 and 40, 4,597 between 40 and 50, 6,176 between 50 and 60, 6,114 between 60 and 70, and 4,132 aged 70 or above. Rs5.104 billion has been spent on dialysis under the programme.

Patients have been receiving dialysis at district headquarters hospitals and medical teaching institutions in Peshawar, Mardan, Swabi, Charsadda, Swat, Nowshera, Abbottabad and Mansehra.

Deceased donor programme

The provincial government set up the Medical Transplantation Regulatory Authority in 2017 to address illegal organ trade. Since then, more than 900 transplants have been conducted in Khyber Pakhtunkhwa, with all donors being family members, including 410 women.

Asif Masood, deputy administrator of the MTRA, said many patients are waiting for kidney and other organ transplants, but the available number of donors falls short of the need. He said that was why a deceased organ donation programme had been launched.

"We have more than 100 potential donors, who have been registered through our online portal. However, random verification has shown that some registrations require further validation,"

The MTRA has also been working to raise awareness about deceased organ donation and has sought support from religious scholars to help encourage donation for patients in need of transplants.

Transplant surgeons said organs from people declared brain dead could save the lives of patients suffering from organ failure. They said families needed to be counselled so they would allow kidneys from deceased relatives to be transplanted into patients whose survival depends on it.

In June 2025, doctors in Khyber Pakhtunkhwa retrieved organs for the first time from a brain-dead donor, a 14-year-old boy named Jawad Khan, and transplanted them into five patients. His uncle, Farhad Khan, was later invited to a seminar on deceased donor transplant at the Pakistan Kidney and Liver Institute and Research Centre in Lahore, where he shared the family’s experience with participants. He said the family had also set up the Jawad Khan Shaheed Organ Donor Foundation to promote deceased organ donation.