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During the congress, E-Posters will be accessible to all participants on the congress website 24/7, as well as in the E-poster stations in the congress center.
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E-Poster Submission Deadline
Please prepare and upload your E-Poster no later than March 14, 2026 11.59PM CET. After this date, you will no longer be able to prepare and upload your E-poster and it will not be displayed and accessible on the congress website.
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Abstract titles should be brief and reflect the content of the abstract.
Despite the well-established benefits of transplantation as renal replacement therapy, access to kidney transplantation in low- and middle-income countries (LMICs) remains disproportionately low. Most transplants in such settings are derived from living donors; however, the rate of living donor renal transplantation (LDRT) remains far below the potential need. The usually reported barriers to renal transplantation are particularly pronounced in countries with evolving healthcare systems, where transplantation programs are often centralized and under-resourced.
Systematic evaluation of these barriers is essential to inform health policy and guide targeted interventions that promote equitable access to transplantation. Understanding the perspectives and challenges of haemodialysis patients can yield critical insights into modifiable obstacles and inform strategies to expand ethical and accessible transplant services within Pakistan and LMIC settings.
A cross-sectional, questionnaire-based study was conducted among patients undergoing maintenance haemodialysis at a tertiary care dialysis centre in Rawalpindi, Pakistan which is not currently a transplant active unit. The centre serves a multi-ethnic population. A total of 112 adult patients with end-stage renal disease (ESRD) receiving regular haemodialysis for at least six months were enrolled through consecutive sampling after obtaining informed consent.
A structured, pretested questionnaire was administered to assess awareness, willingness, and perceived barriers toward living donor renal transplantation (LDRT). Data were analysed using descriptive and inferential statistics to determine the frequency and distribution of key barriers and to explore associations between demographic factors and willingness for transplantation. Ethical approval for the study was obtained.
A total of 112 haemodialysis patients were included. The majority were male (67%) with a mean age of 47 years. Most were married (82%) and underwent dialysis twice weekly (75%) with an average duration of three years. Regarding costs, 87% received full financial support for dialysis. A family history of kidney disease was reported by 30% of participants.
Physician recommendation for transplantation was reported by 82% of patients; however, only 8% were registered with a transplant centre. Awareness regarding kidney transplantation was generally high—81% knew it could be performed from a living donor, 77% understood that donors can live normally post-donation, and 95% recognized the need for lifelong medication. Yet misconceptions persisted, with 72% believing only very close relatives could donate and 88% assuming a perfect and full blood-type match was required.
Although 85% believed religious leaders support organ donation, only 19.5% agreed that religion supports helping others through donation, while 77% remained neutral. Community support for living donation was reported by 69% of respondents. The principal barriers identified were financial constraints (52%), lack of available donors (43%), fear of surgery (26%), fear of graft rejection (56%), along with family opposition and guilt toward potential donors (57%).
Despite these challenges, overall attitudes toward transplantation were positive: 94.7% regarded it as an effective treatment, 88.5% believed it improves quality of life, and 82% would prefer transplantation if cost were not a limitation. Trust in physicians (97%) and confidence in fair treatment within the transplant process (89%) were also high.
These findings indicate a clear gap between knowledge, attitude and practice at a centre where transplantation is not currently performed, and they underscore the need for multifaceted interventions. Routine transplant counselling by dialysis staff, and structured exposure of patients and families to active transplant units to translate willingness into action. Comparative evaluation with transplant-active canters is warranted to identify facilitators and refine policies that promote equitable, access to renal transplantation in Pakistan. Long term goal of deceased donor program with government patronage would help address multiple issues as well.
