# Evaluation of liver transplantation services in Kazakhstan from 2012 to 2023

## TL;DR

This study evaluates liver transplantation services in Kazakhstan from 2012 to 2023, highlighting trends and survival rates for patients awaiting transplants.

## Contribution

The study provides the first comprehensive evaluation of Kazakhstan's liver transplant program and projects future trends.

## Key findings

- The per million population liver transplant rate ranged from 0.35 to 3.77, with a preference for living donor transplants.
- 364 patients on the waiting list did not receive a transplant, with 30-day and 1-year survival rates of 87.0% and 68.0%, respectively.
- Viral hepatitis and cirrhosis prevalence increased from 2015 to 2023 and are projected to continue rising until 2030.

## Abstract

There is a scarcity of publications evaluating the performance of the national liver transplantation (LTx) program in Kazakhstan. Spanning from 2012 to 2023, it delves into historical trends in LTx surgeries, liver transplant centers, and the national cohort of patients awaiting LTx. Survival analysis for those awaiting LTx, using life tables and Kaplan–Meier, is complemented by time series analysis projecting developments until 2030. The overall per million population (pmp) LTx rate varied from 0.35 to 3.77, predominantly favoring living donor LTx. Liver transplant center rates ranged from 0.06 to 0.40. Of 474 LTx patients, 364 on the waiting list did not receive transplantation. The 30-day and 1-year survival rates on the waiting list were 87.0% and 68.0%, respectively. Viral hepatitis and cirrhosis prevalence steadily rose from 2015 to 2023, with projections indicating a persistent trend until 2030. Absent targeted interventions, stable pmp rates of LTx and liver transplant centers may exacerbate the backlog of unoperated patients. This study sheds light on critical aspects of the LTx landscape in Kazakhstan, emphasizing the urgency of strategic interventions to alleviate the burden on patients awaiting transplantation.