The Waiting List Nation: An Exploration of the Kidney Crisis

South Africa has one of the lowest kidney transplant rates in the world — less than three people per million receive a transplant each year, against a global benchmark of fourteen. Behind that number are thousands of patients on a waiting list that moves slowly, if at all: people on dialysis for years, families with willing donors who cannot give, and clinicians who sense that something should be happening differently but are not always sure what or how.

The reasons are not simple. South Africa carries a disease burden that no international guideline was designed for, a public health system whose dialysis capacity has not grown since 1994, and a clinical pathway from sick patient to transplanted patient that passes through too many unsupported decision points.

And yet the science has been moving. South Africa has now performed the first ABO-incompatible kidney transplant on the African continent, reported the first donation after circulatory death kidney transplant in Africa, and published a formal call for a kidney paired exchange programme. The tools exist. The waiting list has not responded. 

The Waiting List Nation convenes a multidisciplinary panel of experts—including a transplant specialist, nephrologist, critical care physician, and transplant coordinator—for a candid, research-led discussion on what is truly limiting South Africa’s kidney transplant programme, and what can be done at every level of care to shift the trajectory.
 

Why You Should Attend

Whether you are a GP, a general physician, a nephrologist, or a specialist in any field, if you manage patients with chronic disease, hypertension, HIV, or diabetes, this session is for you. The decisions that shape whether a patient ever reaches a transplant centre are made in outpatient clinics, in ICUs, and in consulting rooms across the country, not only in transplant programmes. This session gives you the context, the clinical updates, and the practical tools to play your part in closing the gap.

• At the end of this session, you  will :
• Be able to describe the scale and complexity of end-stage renal disease in South Africa, including the disease drivers that make our patient population uniquely challenging.
• Have an understanding of  new transplant pathways now available in South Africa, including ABO-incompatible donation and donation after circulatory death, and identify which patients may benefit
• Recognise the systemic and clinical barriers to organ donation and transplantation — and understand the role non-transplant practitioners play in addressing them.
• Identify when a patient should be referred for organ donor assessment and what that referral would look like.