Renal transplantation from living donors should be seriously considered to help overcome the shortfall in organs
Greater use of kidneys from living donors offers scope for increasing the number of kidney transplants argue Michael Nicholson, Professor of Surgery at Leicester General Hospital and Andrew Bradley, Professor of Surgery at Addenbrookes, in an editorial in this week's BMJ.
Nicholson and Bradley say that 4,500 kidney patients are waiting for transplants in the UK but only one third will receive one within the next year. Deaths from road accidents and strokes have fallen in the last 20 years and the traditional donor pool will therefore not be sufficient to meet demand.
The traditional attitude to living donors has been understandably cautious but the authors point out that 30 per cent of transplants in the US and 45 per cent in Norway are taken from living donors, often the spouse or partner of the recipient. Norway's climate and terrain mean that travel to a dialysis unit may take several hours and living donation has developed as a pragmatic response to the difficulty, the authors say.
The results of living donor kidney transplantation are better than cadaveric transplantation and the risks to the donor are low, with a perioperative mortality of 0.03 percent. Long term prospective follow up of donors would help address the criticism that kidney removal is harmful even in healthy donors.
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Michael L Nicholson, Professor of Surgery, Leicester General Hospital