Introduction: Liver transplantation is a vital therapeutic option for patients with end-stage liver disease. In Saudi Arabia, liver donations have evolved over the years, with contributions from deceased, living related, and living unrelated donors. This study aims to analyze liver donation trends in Saudi Arabia from 1990 to 2022, with particular emphasis on the year 2022.

Methods: A retrospective analysis of liver donation data in Saudi Arabia, obtained from the Saudi Center for Organ Transplantation, was conducted. The data comprised of 1,318 deceased donors, 2,336 living related donors, and 263 living unrelated donors from 1990 to 2022. The total number of liver donations for each year was analyzed, and trends were identified to assess the changing landscape of liver transplantation in Saudi Arabia.

Results: Liver donations from deceased donors increased from 1 in 1990 to 66 in 2022, with the highest annual number of 79 donations in 2017. Living related liver donations rose from none in 1990 to 328 transplants in 2022 which is the highest living related transplants performed. Living unrelated liver donations began in 2010, with a total of 263 donations, with the highest transplant rate of 46 in 2022. The year 2022 witnessed a total of 440 liver donations, which represents the highest annual number of liver donations recorded in Saudi Arabia.

Conclusion: The data reveals a steady increase in liver donation rates in Saudi Arabia from 1990 to 2022, with a remarkable growth in living related donations. The year 2022 recorded the highest number of liver donations, reflecting the ongoing commitment to improving access to liver transplantation for patients with end-stage liver disease. Further research should explore the factors contributing to this trend and investigate strategies to optimize organ donation and transplantation processes, ensuring equitable access to liver transplantation for those in need.