Rise in kidney disease likely to create surge in UAE demand for transplants

Waiting lists for kidney transplants are expected to grow due to rising rates of renal failure, with more specialists required to support those needing lifelong care. The World Health Organisation reports kidney disease has climbed from 19th to ninth on the list of leading causes of death globally, making it an area of concern due to increased levels of hypertension and obesity.

While the UAE has made great strides in transplant surgery since the first kidney was donated to a patient in Dubai in 2016 and more than 120 procedures performed since, doctors said more donors were urgently needed. Cost and access to suitable donors remain significant barriers for those in need of a kidney transplant, but the Hayat Organ Donation Programme is one national initiative plugging gaps by encouraging organ and tissue donations.

The Your Donation Saves Lives campaign raises funds in partnership with Dubai Health and the Al Jalila Foundation to support those in need of a transplant. In five years, the number of annual donors in Dubai has risen from around 20 to almost 100, but with worldwide deaths related to renal disease climbing 95 per cent this century, it is an expanding area of health care, experts said.

Dr Waldo Concepcion, a transplant surgery consultant at Dubai Health has replaced more than a thousand kidneys in his 35-year medical career and 160 in the UAE, and expects that number to continue to grow. “No question we would expect to see more kidney disease in the future and more demand for transplants,” said Dr Concepcion.

“Obesity, hypertension and diabetes in Dubai is really increasing. And unless we create this as a public health initiative to really get serious about controlling this, that includes education, dietary supplements and preventive measures, it will be difficult to manage.

“Donation has improved, but it's not even close to what we need to provide for our population. When I arrived in Dubai five years ago we had 22 donors a year, now we are close to 100. It's a good number, but not even close to provide for the needs.”

Anyone aged 18 with a valid Emirates ID can register to become a donor to offer life-saving help. Potential donors can register online with the Ministry of Health and Prevention to receive an e-donor card. Surgeries are performed at nine UAE hospitals under the national transplant programme. In Dubai, King's College Hospital London, Dubai Hospital, Mediclinic Hospital and Al Jalila Specialist Hospital for Children are approved centres.

“The surgery is just a few hours, but the issue is the preparation and long-term care patients need,” said Dr Concepcion, who is also a professor of surgery at Mohammed Bin Rashid University of Medicine and Health Sciences (MBRU). “The difficulty is finding a team of nephrologists that can stick around, follow the patient and manage them carefully to have good long-term survival. If a hospital wants to be a transplant centre, it needs resources to provide all the support for these patients. It is care for life.”

Global trend

Hypertension and diabetes accounts for more than 65 per cent of all adult patients going to transplant, while in children the most common causes of kidney disease are congenital conditions. Of all transplants conducted worldwide, around two thirds are kidneys which can last up to 20 years, depending on the recipient’s age, health and dietary habits. The organ donation and transplantation programme at Dubai Health collaborates with the National Centre for Organ and Tissue Donation and Transplantation in MOHAP and the Dubai Health Authority (DHA).

From 2018 to July 2024, 72 kidney transplants were performed, with 47 transplants at Al Jalila Children's Hospital and 25 at Dubai Hospital. Rashid Hospital is the leading organ donation hospital in the UAE, with more than 50 organ donors contributing to over 180 organ transplants.

One of those patients is Jatin Ravindra Chilekar, an Indian national who has lived in Dubai since 2017 with his wife and 10-year-old daughter, who was diagnosed with kidney disease in 2019. Despite having good health insurance that covered organ transplants, hospitals listed in his coverage were not part of the UAE’s transplant programme.

“When I was told I needed a transplant two years ago, we tried every opportunity to make it happen,” said Mr Chilekar, who received a new kidney in August. However, his insurance didn't cover him for a transplant in the UAE.

Kidney failure

After a bout of Covid-19, Mr Chilekar’s kidneys failed completely in August 2022 and he began weekly dialysis to replicate the organs' job of flushing toxins from the body. He considered getting a loan and returning to India for a transplant.

But with around 70,000 people on the waiting list he was told it would take at least three years to find a suitable match, he said. This continued for two years until he was eventually put in touch with the Al Jalila Foundation to find a donor.

“There are huge mental pressures – I am a strong person, but sometimes I would feel very weak,” said Mr Chilekar. “The transplant has changed my life in a way I cannot express. No words describe the thanks I have for the person who has donated this kidney, and their family.”

Kidney disease is increasing globally and disproportionately affects poor, vulnerable and marginalised populations as it is associated with high care costs and costs to society. Some 700 million people are understood to have chronic kidney disease around the world.

In 2022, there were 39,196 kidney transplants in the Americas, 25,329 transplants in Europe and 18,219 in the Western Pacific region. The Eastern Mediterranean region had just 6,363 kidney transplants that year, and Africa just 286.

Alusine Jalloh, a 38 year old from Sierra Leone, also received life-saving support in Dubai thanks to a selfless donor. Mr Jalloh first came to Dubai 12 years ago to help his mother establish an African logistics company. He was diagnosed with kidney disease in 2018, and struggled to meet the $400 weekly dialysis costs and almost gave up hope of a transplant.

“I stayed strong, and even kept it from some of my friends as the doctors said the only solution was a transplant,” said Mr Jalloh, who has two children aged six and four. “I had financial problems and a serious health problem, so it was difficult to manage.”

Suitable match

A social worker connected him with doctors at Mediclinic Hospital in Dubai who took on his case. “One of my cousins was willing to give me a kidney, but unfortunately it wasn’t a suitable match,” said Mr Jalloh.

“A few weeks later the hospital said they had found a donor and everything moved very quickly. It was a miracle, I feel so very lucky. I wish something like this could be extended to the less privileged in Africa, specifically Sierra Leone – a lot of people there need these opportunities. If this had happened to me there, I’m not sure if I would have survived this.”