AUTHOR=Malik Fatima , Khan Bhettani Mehreen , Mansoor Junaid , Arslan Zainab , Khan Muhammad Shamim , Amin Irum , Farid Shahid , Haroon Usman , Ahmed Zubir , Khurram Muhammad , Zakri Rhana , Sharif Adnan TITLE=Evolving Trends in Organ Donation and Transplantation Rates Across Muslim Majority Countries JOURNAL=Transplant International VOLUME=Volume 38 - 2025 YEAR=2025 URL=https://www.frontierspartnerships.org/journals/transplant-international/articles/10.3389/ti.2025.15116 DOI=10.3389/ti.2025.15116 ISSN=1432-2277 ABSTRACT=Muslim-majority countries differ in socio-cultural behavior and economic development but share a similar high burden of organ failure. Due to this heterogeneity, mapping organ donation and transplantation activity is of interest for future healthcare provision. Data was analyzed for 50 Muslim-majority countries (defined as Muslims comprising >50% of the population). Organ donation/transplantation rates were obtained from global registries between 2013–2023. Supplementary socio-economic and health data were obtained from open-source data repositories. Muslim-majority countries population increased from 1.53 billion to 1.88 billion between 2013–2023. Organ donation/transplant activity was only reported for 21/50 countries. Most organ donations came from living people rather than deceased donors (resulting in kidney and liver transplantation being the most common procedures). Other transplant activity rates were low. Poisson regression analyses identified multiple socioeconomic indicators to be associated with deceased- or living-donor activity, while negative binomial analyses comparing Muslim-majority to other countries within the region showed Muslim countries had lower deceased donation rates. Our study shows access to transplantation is lacking in many Muslim-majority countries. While socio-economic factors play a role, other challenges like religious and/or cultural barriers must be appreciated. With such global heterogeneity, bespoke country-specific interventions are warranted to improve transplantation opportunities in Muslim-majority countries.