Brazil's Kidney Transplant Shift: Fewer Living Donors, More Deceased

The waiting list for kidney transplants in Brazil grew by fifteen percent between 2010 and 2023. It went from about thirty-three thousand to over thirty-eight thousand people. At the same time the total number of transplants rose by twenty-nine percent. That means more surgeries overall but the mix changed a lot.

Deceased donor transplants jumped from three thousand to almost five thousand two hundred. Living donor transplants dropped from one thousand six hundred fifty-five to eight hundred fifty-eight. The share of living donor procedures fell from thirty-five percent to just fourteen percent. The rate per million people also fell from eight point eight to four point two.

Among living donors the pattern shifted. Related donors went down from eighty-two percent to seventy-one percent. Spouse donors went up from ten percent to almost nineteen percent. Other unrelated donors rose from six percent to ten percent.

Data shows living donor transplants had better published survival numbers for patients and grafts. Hospitals also reported lower in-hospital death rates, shorter stays, and lower admission costs for living donor cases. These are descriptive findings not proof of cause.

The authors suggest Brazil needs combined strategies to keep deceased donor supply strong while also boosting living donor programs. They caution that the comparisons are only observational.