by Galiya Khassenkhanova
It's published •update
In many cases, organ transplantation, the only way to save lives, is directly dependent on donors. However, sometimes unreliable availability often leads to patients dying before receiving the donated organ.
There are two types of organ donation: a living donor and a cadaveric transplant. While living donor options are generally limited to only the kidneys and liver, in Kazakhstan, there is a tendency to save more lives than post-mortem donations.
“With 80-90% of donations worldwide, 80 to 90% are posthumous, the same cannot be said for Kazakhstan and Central Asia countries. In our country, Aoutshitkazinov of the Republican Centre for the Coordination of Kazakhstan's Transplantation and High Tech Services, said.
He said the reason many people refuse to donate organs after death is a lack of trust in the health care system.
The belief that corruption is everywhere makes us fear that donated organs will be misused or illegally sold, or that doctors will not treat patients and reach the organ.
Sitkazinov points out that selling organs is punished by Kazakh law. At the same time, dozens of people and several tissues are involved in organ transplant procedures, and hospitals are not getting financial or other benefits if the patient becomes a donor after death.
Still, he understands that scandals surrounding organ transplants often prevent people from signing donation forms.
Last year alone, there were 15 cases in which people tried to sell donated organs.
Religion also plays a role. Many believe that Islamic or Orthodox Christianity – two major religions in Central Asia – does not allow post-mortem contributions. All Kazakhstan religious authorities support post-mortem contributions as a charity act, but that has not yet shaken many.
Religious issues are not endemic to Kazakhstan or Central Asia. Research shows that donating postmortem organs is a long-standing trend in Islamic countries where donating blood is widespread.
In contrast, in Europe, post-mortem organ donation is an established practice, covering up to 50% of the organ needs. Unlike other parts of the world, Europe also uses organs of donors who died from heart failure.
Current Situation in Kazakhstan
As of May 2025, 4,226 people in Kazakhstan were on the waiting list for some type of organ donation, of which 128 were children.
Of the total number of patients, 3,828 are waiting for the kidneys, but in the worst case scenario of no donors found, those patients have hemodialysis options and can survive for 10 to 15 years.
“Not everyone who needs an organ transplant is on this list. There are no other options in this category, and only organ transplants can save lives,” emphasized the director of transplantation cooperatives.
He says that on average 300 people die simply because there are not enough organ donors.
“I give you a simple example. In 2024, there were 86 deceased donors diagnosed with brain death. All relatives were approached and only 10 families agreed,” Sitkazinov said.
Kazakhstan has an opt-in consent system, with each citizen having to officially agree to donate their organs after death. However, even if the person agrees, their relatives must also agree.
The system was introduced in 2020 after several lawsuits from relatives of deceased people who were furious that the organs were extracted without consent.
In 2024, there were 260 transplants, of which 237 were from living donors.
“The main issue is the rejection of relatives. We also have a very low expression of will. As of January 2025, the adult population was 11 million, with 115,000 expressing their willingness to opt out, and only 8,000 opted in,” Sitkazinov said.
All Central Asian countries share similar issues regarding post-mortem contributions. A lack of trust in the system and a misconception about the donation itself.
The number of organ donations from deceased is unlikely to grow large until public awareness is increased, the system is proven to be more transparent and to ensure the number of organ donations from deceased people.
