Global Perspectives on Renal Transplantation in Chronic Kidney Disease: A Systematic Review of Adult and Geriatric Populations in Europe and Indonesia

Background: Chronic Kidney Disease (CKD) has become a significant global health issue, especially among the aging population. Renal transplantation is considered the most effective treatment for end-stage renal disease (ESRD), yet disparities exist in its accessibility and outcomes across different regions. Objectives: This study aimed to compare the perspectives and outcomes of renal transplantation in adult and geriatric patients with CKD in Europe and Indonesia, highlighting differences in healthcare systems, patient management, and socio-cultural considerations. Methods: A literature review was conducted using PubMed, ScienceDirect, and Google Scholar, focusing on publications from the last 10 years. Studies involving adult and elderly CKD patients undergoing renal transplantation in both Europe and Indonesia were analyzed for themes related to access, outcomes, quality of life, and post-transplant management. Results: European countries generally demonstrated more structured transplantation programs, better post-operative care, and higher graft survival rates due to strong infrastructure and funding. In contrast, Indonesian patients faced challenges such as limited donor availability, economic constraints, and lower awareness about transplantation. Geriatric patients in both regions exhibited more complications post-transplantation compared to younger adults, but still benefited in terms of survival and quality of life. Discussion: Disparities between Europe and Indonesia in renal transplantation stem from differences in healthcare access, government support, and patient education. Cultural and ethical issues also influence organ donation rates. Despite challenges, renal transplantation remains a viable option for geriatric patients, especially with proper selection and monitoring. Conclusion: While renal transplantation offers improved outcomes for CKD patients globally, substantial disparities remain between regions. Efforts to enhance transplantation programs in developing countries like Indonesia are crucial, especially in addressing the needs of the aging population.