Scaling Up HIV Self-Testing and Linkage to Care Among Women Who Exchange Sex and/or Use Drugs in Kazakhstan.

HIV testing is the point of entry for linkage to treatment and prevention and is critically important to ending the HIV epidemic. HIV self-testing (HST) is an acceptable, user-controlled tool that can address testing barriers, which is especially important for populations who need to test frequently, like women who exchange or trade sex for money or other needed resources (WES) and women who use drugs. HST is feasible and acceptable among WES, but research among WES who also use drugs is limited, particularly in places like Kazakhstan, where HIV rates remain high and where scale-up of HST and pre-exposure prophylaxis (PrEP) is in process. To develop effective programming, there is a need to develop tailored services for WES and/or use drugs that address key barriers. We discuss opportunities to increase HST and linkage to services among WES and/or use drugs in Kazakhstan, with a focus on stigma reduction.

Factors associated with maternal mortality in Kazakhstan: a pre- and during-pandemic comparison.

Introduction: The maternal mortality indicator serves as a crucial reflection of a nation's overall healthcare, economic, and social standing. It is necessary to identify the variations in its impacts across diverse populations, especially those at higher risk, to effectively reduce maternal mortality and enhance maternal health. The global healthcare landscape has been significantly reshaped by the COVID-19 pandemic, pressing disparities and stalling progress toward achieving Sustainable Development Goals, particularly in maternal mortality reduction. Methods: This study investigates the determinants of maternal mortality in Kazakhstan from 2019 to 2020 and maternal mortality trends in 17 regions from 2000 to 2020, employing data extracted from national statistical reports. Stepwise linear regression analysis is utilized to explore trends in maternal mortality ratios in relation to socioeconomic factors and healthcare service indicators. Results: The national maternal mortality ratio in Kazakhstan nearly tripled from 13.7 in 2019 to 36.5 per 100,000 live births in 2020. A remarkable decrease was observed from 2000 until around 2015 with rates spiked by 2020. Significant factors associated with maternal mortality include antenatal care coverage and the number of primary healthcare units. Additionally, socioeconomic factors such as secondary education enrollment and cases of domestic violence against women emerged as predictors of MMR. Moreover, the impact of the pandemic was evident in the shift of coefficients for certain predictors, such as antenatal care coverage in our case. In 2020, predictors of MMR continued to include secondary education enrollment and reported cases of domestic violence. Conclusion: Despite Kazakhstan's efforts and commitment toward achieving Sustainable Development Goals, particularly in maternal mortality reduction, the impact of the COVID-19 pandemic poses alarming challenges. Addressing these challenges and strengthening efforts to mitigate maternal mortality remains imperative for advancing maternal health outcomes in Kazakhstan.

Forensic evaluation of craniometric characteristics of the Kazakhstan population.

Background: The human skull is the part of the skeleton most frequently used in population studies, as it was more exposed to genetic factors and less exposed to environmental factors. The skull is an important component in human forensic identification. Materials and methods: The craniometric characteristics of 186 male and 114 female skulls found on the territory of Kazakhstan were studied. Dimensions were measured using standard anthropometric methods and instruments. The results of measurements of 25 craniometric parameters are presented. Methods of descriptive and parametric statistics were used. Results: Statistical analysis showed significant regional dimorphism, confirming theindividuality of the Kazakhstan population. Statistically significant deviations werefound in 6 male craniometric characteristics and 4 female craniometric characteristics(p<0.05). The most dimorphous variables for regional identification in Kazakhstanmales were the higher skull base and frontal chord width , full face height , condylarand bigonial width , and low mandibular body reference values (p<0.05). For females,significant statistical discrepancies were seen in the transverse diameter and skullbase width, mastoid and occipital aperture width (p<0.05). Conclusion: The recorded variations and changes in the morphology of the humanskull of the population of Kazakhstan indicate the need to develop and updateosteometric standards used in practice for specific populations. All this will significantlyimprove the accuracy of forensic identification and more fully study the biologicalpatterns of population formation, as well as evaluate the comparative effectiveness ofindividual features in the reconstruction of the population history of various populationgroups.

Hybrid versus traditional method closure of ventricular septal defects in children.

Objective: The aim of our study was to evaluate the safety and effectiveness of the hybrid method off-pump for closure of isolated ventricular septal defect (VSD) compared with the traditional method of on-pump of children. Methods: This research was a retrospective cohort study. Data were collected from 500 patients with isolated VSD (or residual VSD after a previous repair) who underwent surgery at the National Scientific Medical Center from May 2016 to December 2020. Patients were operated with 1 of 2 methods of surgery: the traditional method of on-pump or the hybrid method of off-pump. This study assessed the safety and efficacy of the hybrid method by comparing it with the traditional method for the treatment of patients with isolated VSD. Results: The procedural success rate reached 93.2% in the hybrid method, with a 6.4% conversion rate to the traditional method and 0.4% hospital mortality. The mean operation time was 84 minutes (31; 160 minutes) in the hybrid group (n = 250) and 168 minutes (70; 300 minutes) in the traditional group (n = 250) (P = .000). Hospital mortality was 0.43% in the first group and 1.5% in the second group (P = .000). Conclusions: The hybrid method of VSD closure is safe and effective in a selected group of patients. The advantages of the hybrid method are improved cosmetics and shorter operation time and overall hospital stay.

Cystic echinococcosis of the liver in Kazakhstan: The effectiveness of the PAIR method in comparison with laparoscopic and «open¼ surgical methods.

BACKGROUND: One of the urgent problems of surgical parasitology in the Republic of Kazakhstan is liver cystic echinococcosis. The study aimed to analyze the effectiveness and safety of the percutaneous treatment with different techniques in comparison with the results of laparoscopic and "open" surgical methods. METHODS: Retrospectively, we analyzed the outcome of 485 patients with active echinococcal cysts in the period from January 2017-July 2023. Indications for surgical treatment and the choice of the intervention method were based on this classification. Patients were conditionally divided into 3 groups: Laparoscopy-33, Laparotomy-319, PAIR-133. RESULTS: The duration of the operation in the PAIR was significantly shorter compared to the Laparotomy and Laparoscopy groups (55.4vs.225.2 and 215.3, p = 0.0001). There was no intraoperative blood loss in PAIR, whereas in Laparotomy and Laparoscopy there were 146.0 and 111.0. The postoperative stay of patients in PAIR is significantly shorter than in Laparotomy and Laparoscopy (3.8 compared to 7.5 and 6.4, p = 0.0001). The follow-up time averaged 39.8 months ± 21. There were no statistically significant differences in relapses. Laparotomy and PAIR groups had 11 (3.5 %) and 6 (4.5 %) relapses, respectively. CONCLUSION: In cystic echinococcosis of the liver types CE1, CE3a regardless of the localization, the optimal volume is a PAIR is characterized by a shorter postoperative stay of the patient, early recovery and cure. In the CE2, CE3b stages, laparoscopic pericystectomy is the most effective and safe in individual patients. In case of an intimate arrangement of cysts to tubular structures, the safest method is laparotomy.

Corporate social responsibility and firm performance: Case of Kazakhstan.

The research seeks to find a relationship between Corporate Social Responsibility (CSR) and companies' performance. Studied variables were measured and analysed using a sample of companies listed on the Kazakhstan Stock Exchange (KASE). The study employed the regression model and least squares technique as the primary analytical tools. CSR is examined in conjunction with variables such as Return on Assets, Return on Equity, Market Value, and Net Profit Margin. As a result of the research, it was found that firm performance and CSR relate to each other in the studied companies. The research found a positive correlation between CSR practices and Net Profit Margin in Kazakh companies. While this study focused on a single country, its methodology can be applied to research in other emerging and developing nations. The primary contribution of this research is the examination of the relationship between firm performance and CSR practices in the post-Soviet emerging market of Kazakhstan.

Combining Thermal Effect and Mobility Control Mechanism to Reduce Water Cut in a Sandstone Reservoir in Kazakhstan.

The application of polymer flooding is currently under investigation to control water cut and recover residual oil from a giant sandstone reservoir in Kazakhstan, where the water cut in most producers exceeds 90%, leaving substantial untouched oil in the porous media. The primary objective of this research is to explore the feasibility of a novel approach that combines the mechanisms of mobility control by polymer injection and the thermal effects, such as oil viscosity reduction, by utilizing hot water to prepare the polymer solution. This innovative hybrid method's impact on parameters like oil recovery, resistance factor, and mobility was measured and analyzed. The research involved an oil displacement study conducted by injecting a hot polymer at a temperature of 85 °C, which is higher than the reservoir temperature. Incremental recovery achieved through hot polymer injection was then compared to the recovery by conventional polymer flooding and the conventional surfactant-polymer-enhanced oil recovery techniques. The governing mechanisms behind recovery, including reductions in oil viscosity, alterations in polymer rheology, and effective mobility control, were systematically studied to comprehend the influence of this proposed approach on sweep efficiency. Given the substantial volume of residual oil within the studied reservoir, the primary objective is to improve the sweep efficiency as much as possible. Conventional polymer flooding demonstrated a moderate incremental oil recovery rate of approximately 48%. However, with the implementation of the new hybrid method, the recovery rate increased to more than 52%, reflecting a 4% improvement. Despite the polymer's lower viscosity during hot polymer flooding, which was observed by the lower pressure drop in contrast to the conventional polymer flooding scenario, the recovery factor was higher. This discrepancy indicates that while polymer viscosity decreases, the activation of other oil displacement mechanisms contributes to higher oil production. Applying hybrid enhanced oil recovery mechanisms presents an opportunity to reduce project costs. For instance, achieving comparable results with lower chemical concentrations is of practical significance. The potential impact of this work on enhancing the profitability of chemically enhanced oil recovery within the sandstone reservoir under study is critical.

Examining a 12-year experience within Kazakhstan's national heart transplantation program.

Kazakhstan has one of the lowest heart transplantation (HTx) rates globally, but there are no studies evaluating the outcomes of HTx. This study aimed to provide a comprehensive analysis of the national HTx program over a 12-year period (2012-2023). Survival analysis of the national HTx cohort was conducted using life tables, Kaplan‒Meier curves, and Cox regression methods. Time series analysis was applied to analyze historical trends in HTx per million population (pmp) and to make future projections until 2030. The number of patients awaiting HTx in Kazakhstan was evaluated with a regional breakdown. The pmp rates of HTx ranged from 0.06 to 1.08, with no discernible increasing trend. Survival analysis revealed a rapid decrease in the first year after HTx, reaching 77.0% at 379 days, with an overall survival rate of 58.1% at the end of the follow-up period. Among the various factors analyzed, recipient blood levels of creatinine and total bilirubin before surgery, as well as the presence of infection or sepsis and the use of ECMO after surgery, were found to be significant contributors to the survival of HTx patients. There is a need for public health action to improve the HTx programme.

Genetic diversity and haplotype analysis of cattle hydatid cyst isolates using mitochondrial markers in Kazakhstan.

Background and Aim: In Kazakhstan, the study of Echinococcus infection among farm animals is crucial to monitor the invasion among livestock and map the data obtained. Unfortunately, there are only partial data on the study of Echinococcus among cattle's in Kazakhstan, which makes it difficult to conduct a comparative analysis of the epidemiological situation among livestock animals. The present study aimed to molecularly identify the species and haplotypes of the E. granulosus complex infecting cattle in Kazakhstan and investigate their genetic variation relative to mitochondrial (mt) targets. Materials and Methods: Individual cyst isolates (n = 700) were collected from infected cattle lungs and livers after slaughter from the slaughterhouse. Total DNA was extracted from the germinal layers of the cyst from each isolate. This DNA sequenced partial mt genes of cytochrome c oxidase 1 (450 bp) and NADH dehydrogenase 1 (1200 bp). Results: We determined that all the sequences were detected as E. granulosus s.s., of which 69 (94.5%) samples belonged to G1, and only 4 (5.4%) samples belonged to the G3 genotype. After bioinformatic analysis, 38 haplotypes were identified. Conclusion: Our findings revealed that the G1 genotype of E. granulosus s.s. is the predominant cattle genotype in Kazakhstan. However, only one region showed the presence of two genotypes G1 and G3, in the sequence, which suggests that further research is needed to investigate the epidemiology of Echinococcus infection in cattle in Kazakhstan.

Knowledge, Attitudes, and Practices of Sun Exposure and Sun Protection among the Population of Kazakhstan: A Cross Sectional Study.

OBJECTIVE: The aims of this study were to assess knowledge, attitudes, and practices regarding sun exposure and sun protection among the population of Kazakhstan. METHOD: A cross sectional study was conducted by administering an online questionnaire via social networking sites to residents of Kazakhstan. The questionnaire was designed to determine demographic information as well as knowledge, attitudes and practices regarding sun exposure and sun protection. RESULT: The responses of 249 participants were analysed.  Descriptive tests, bivariate analyses, and multiple linear regression were used to statistically analyse the data. The mean age of the participants was 31.7 ± 11.5 (SD) years. Most participants were of Kazakh nationality (88.7%), female (71.0 %), urban residents (93.9 %), and possessed higher education degrees (88.0 %). The level of knowledge and attitudes were found to be moderate amongst the population whilst practices were determined to be low.  Knowledge (p=0.002), attitudes (p=0.002), female gender (p=0.002), and having children educated in school about sun safety (p=0.018) were significantly associated with improved sun-protective practices. CONCLUSION: This study has demonstrated low adoption of sun protective practices in the Kazakhstan population, despite the identification of certain characteristics associated with higher rates of practice.

Liver Cancer Incidence in Kazakhstan: Fifteen-Year Retrospective Study.

OBJECTIVE: The aim is to study the trends of liver cancer (LC) incidence in the regional context in Kazakhstan. METHODS: The retrospective study was done using descriptive and analytical methods of oncoepidemiology. The extensive, crude and age-specific incidence rates are determined according to the generally accepted methodology used in sanitary statistics. The data were used to calculate the average percentage change (APС) using the Joinpoint regression analysis to determine the trend over the study period. RESULTS: Between 2005 and 2019, 13,510 cases of LC were documented, comprising 59.3% males and 40.7% females. Most diagnoses were seen in age groups 55-59 years (13.3%) to 75-79 years (11.7%). LC patients' average age increased from 63.6 to 64.5 years. Incidence rates per 100,000 peaked at ages 65-69 years (35.1±1.0) and 70-74 years (43.3±1.0). LC incidence notably rose in the 70-74 years age group (APC=+0.89), contrasting with declining trends in younger age groups. Regional incidence variations revealed diverse patterns, mostly demonstrating unimodal increases, and some regions displaying bimodal growth. The age-standardized incidence rate was 5.7±0.1 per 100,000, declining from 2005 to 2012 (APC: -3.93), then rising until 2019 (APC: +1.13). Gender-specific standardized rates showed varied trends. Analyses of standardized indicators indicated declining trends in most regions but increased values in specific areas. Thematic maps classified incidence rates based on standardized indicators: low (up to 5.22), average (5.22 to 7.11), high (above 7.11 per 100,000 for the entire population). CONCLUSION: The study on liver cancer in Kazakhstan reveals marked gender and age differences. The standardized incidence rate among men was twofold greater than that among women. A distinct rise in cases was noted among individuals aged 70-74 years. Regional variations in incidence were evident. These findings emphasize the necessity for focused research to comprehend the causes behind these differences, enabling customized interventions for Kazakhstan's population.

General, Vaccination, Navigational and Digital Health Literacy of Students Enrolled in Different Medical and Health Educational Programs.

Evaluating prospective graduates' health literacy profiles before they enter the job market is crucial. Our research aimed to explore the health literacy levels of medical and health students by assessing their ability to obtain health-related information, understand healthcare systems, use e-health, and be informed about vaccination as well as to explore the factors associated with health literacy. Short versions of the HLS19-Q12 were used for a cross-sectional survey that was carried out among 1042 students enrolled in various medical and health educational programs at three medical universities in Kazakhstan between September and November of 2023. Additionally, instruments such as Digital Health Literacy (HLS19-DIGI), Navigational Health Literacy (HLS19-NAV), and Vaccination Health Literacy (HLS19-VAC) were employed. The score of General Health Literacy was 88.26 ± 17.5. One in eight students encountered difficulties in Vaccination Health Literacy. Despite overall high health literacy, Navigational Health Literacy posed challenges for all students. The Public Health students exhibited the highest General Health Literacy (91.53 ± 13.22), followed by students in Nursing, General Medicine, other educational programs (Dentistry and Biomedicine) and Pharmacy. Financial constraints for medication and medical examinations significantly influenced health literacy across all types of individuals. Since comprehensive health literacy instruction or interventions are still uncommon in the curricula, it seems reasonable to develop and incorporate appropriate courses for medical and health educational programs.

Historical evolution of healthcare systems of post-soviet Russia, Belarus, Kazakhstan, Kyrgyzstan, Tajikistan, Turkmenistan, Uzbekistan, Armenia, and Azerbaijan: A scoping review.

This scoping review addresses the transformation and development of new healthcare systems in nine countries -Armenia, Azerbaijan, Belarus, Kazakhstan, Kyrgyzstan, Russia, Tajikistan, Turkmenistan, and Uzbekistan over the period following the collapse of the Soviet Union from 1991 to the present. This assessment focuses on maternal and child health, mental health, communicable diseases, and non-communicable diseases in an effort to highlight the changes in the healthcare status of these nine countries under scrutiny. Considering that all the post-Soviet nations are officially recognized members of the World Health Organization (WHO) and have demonstrated their commitment to attaining the WHO's objectives, the evaluation of healthcare system progress and improvement was carried out utilizing indicators provided by the WHO. This review reveals that the evolution of healthcare systems could be considered sustainable, given that average life expectancy has returned to the level it was in 1991- the year of the USSR's breakup, and people's health has improved since the turn of the twenty-first century. To enhance the potential success of future healthcare reforms, however, governments must monitor implementation of the reform process, evaluate the achievement of objectives, and make necessary adjustments. The success of future healthcare changes will depend on the active involvement of the government, medical community, and patient community, as well as obtaining the support of local health authorities. This study may help identify successful and failed strategies, guiding future healthcare changes and investments.

Awareness of Autism Spectrum Disorder Among Population of Kazakhstan.

BACKGROUND: In recent years, an abundance of research has substantiated the escalating prevalence of Autism Spectrum Disorder (ASD) on a global scale. The aim to assess the level of awareness regarding ASD among the Kazakhstan population, as well as their readiness to offer help to individuals affected by ASD. METHODS: A cross-sectional study was conducted encompassing individuals aged 18 years and above, using both the Russian and Kazakh languages. The survey was administered through Google Forms during April to June 2023. The link to survey was disseminated through WhatsApp chats of different social groups, including primary care specialists (general practitioners and nurses), and educators from primary and secondary schools from all 17 regions of Kazakhstan, spanning urban and rural areas. 410 participants took part in the survey in total. Statistical significance will be defined as p-values < 0.05. RESULTS: Individuals aged 25 and above, who are both educated and employed, exhibit a greater awareness of ASD compared to other demographic groups. A low proportion of respondents (18.3%) demonstrated familiarity with the key symptoms of ASD as well as on its causes. Furthermore, it's noteworthy that the primary resource for acquiring information about ASD was the internet for both of these regions. CONCLUSION: Low awareness on ASD symptoms and treatment methods was identified in both areas. There is a need to develop activities to increase the public awareness on ASD, including knowledge on early symptoms of ASD and facilities that address the needs of people on the ASD and their families.

A severe case of Plasmodium falciparum malaria in a traveler returning from Kazakhstan, a malaria-free country.

Following a 2-week trip to Kazakhstan, a 42-year-old woman presented at the emergency department in Germany with fever, headache, nausea, and neurological symptoms. An infection with Plasmodium falciparum was rapidly diagnosed. The patient was immediately treated with intravenous artesunate and transferred to an intensive care unit. The initial parasite density was as high as 30% infected erythrocytes with 845,880 parasites/µL. Since Kazakhstan was declared malaria-free in 2012, molecular testing for Plasmodium has been initiated to identify a possible origin. Genotyping of the msp-1 gene and microsatellite markers showed that the parasites are of African origin, with two different alleles indicating a polyclonal infection. After a hospitalization of 10 days, the patient was discharged in good health. Overall, our results emphasize that malaria must be on the list of differential diagnoses for patients with fever of unknown origin, even if they come from countries where malaria does not commonly occur.

Transcriptome profiling and analysis of patients with esophageal squamous cell carcinoma from Kazakhstan.

Esophageal squamous cell carcinoma (ESCC) is the predominant subtype of esophageal cancer in Central Asia, often diagnosed at advanced stages. Understanding population-specific patterns of ESCC is crucial for tailored treatments. This study aimed to unravel ESCC's genetic basis in Kazakhstani patients and identify potential biomarkers for early diagnosis and targeted therapies. ESCC patients from Kazakhstan were studied. We analyzed histological subtypes and conducted in-depth transcriptome sequencing. Differential gene expression analysis was performed, and significantly dysregulated pathways were identified using KEGG pathway analysis (p-value < 0.05). Protein-protein interaction networks were constructed to elucidate key modules and their functions. Among Kazakhstani patients, ESCC with moderate dysplasia was the most prevalent subtype. We identified 42 significantly upregulated and two significantly downregulated KEGG pathways, highlighting molecular mechanisms driving ESCC pathogenesis. Immune-related pathways, such as viral protein interaction with cytokines, rheumatoid arthritis, and oxidative phosphorylation, were elevated, suggesting immune system involvement. Conversely, downregulated pathways were associated with extracellular matrix degradation, crucial in cancer invasion and metastasis. Protein-protein interaction network analysis revealed four distinct modules with specific functions, implicating pathways in esophageal cancer development. High-throughput transcriptome sequencing elucidated critical molecular pathways underlying esophageal carcinogenesis in Kazakhstani patients. Insights into dysregulated pathways offer potential for early diagnosis and precision treatment strategies for ESCC. Understanding population-specific patterns is essential for personalized approaches to ESCC management.

The impact of incentive scheme on rural healthcare workforce availability: a case study of Kazakhstan.

BACKGROUND: During the 1990-2000, Kazakhstan experienced a decline in the number of healthcare professionals working in rural areas. Since 2009, the national government has been implementing financial incentives to encourage healthcare professionals to relocate to rural areas. This study aims to investigate the temporal and spatial patterns in the distribution of the rural healthcare workforce and evaluate the impact of this incentive scheme. METHODS: Interrupted Time Series Analysis using ARIMA models and Difference in Differences analyzes were conducted to examine the impact of the incentive scheme on the density of different categories of the healthcare workforce in rural Kazakhstan in the period from 2009 to 2020. RESULTS: There was a significant increase in the number of rural healthcare professionals from 2009 to 2020 in comparison to the period from 1998 to 2008. However, this increase was less pronounced in per capita terms. Moreover, a decline in the density of internists and pediatricians was observed. There is substantial variation in the density of rural nurses and physicians across different regions of Kazakhstan. The incentive scheme introduced in 2009 by the government of Kazakhstan included a one-time allowance and housing incentive. This scheme was found to have contributed insignificantly to the observed increase in the number of rural healthcare professionals. CONCLUSION: Future research should be undertaken to examine the impact made by the incentive scheme on other medical subspecialties, particularly primary practitioners. Addressing the shortage of healthcare workers in rural areas is a complex issue that requires a multifaceted approach. Aside from financial incentives, other policies could be considered to increase relocation and improve the retention of healthcare professionals in rural areas.

The Role of Climatic, Environmental and Socioeconomic Factors in the Natural Movement of Urban Populations in Kazakhstan, 2012-2020: An Analysis from a Middle-Income Country in Central Asia.

BACKGROUND: This study addresses the importance of identifying key characteristics influencing demographic indicators for urban populations, emphasizing the need to consider regional climatic features and ecological factors. The research utilized data from ten main regional cities across the Republic of Kazakhstan. METHODS: This study involved a retrospective analysis based on secondary data from official sources spanning 2012-2020. We employed correlation analysis and multidimensional regression models. RESULTS: Noteworthy predictors for crude birth rate included the influence of effective temperature (ß = 0.842, p < 0.0001), marriage rate (ß = 0.780, p < 0.0001), Gini coefficient (ß = -27.342, p = 0.020) and divorce rate (ß = -2.060, p < 0.0001), with overall strong model performance (R2 = 0.940). The degree of atmospheric pollution (ß = -0.949, p = 0.044), effective temperature (ß = -0.294, p < 0.0001) and Gini coefficient (ß = 19.923, p = 0.015) were the predictors for crude mortality rate, with a high model fit (R2 = 0.796). CONCLUSIONS: The study unveils significant relationships between demographic indicators (crude birth rate, mortality rate) and variables like effective temperature, marriage rate, divorce rate, Gini coefficient, physician density and others. This analysis of climatic, environmental, and socioeconomic factors influencing demographic indicators may help in promoting specific measures to address public health issues in Kazakhstan.

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

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.