Journal Article

Workload generated by a living donor programme for renal transplantation

Richard N. Saunders, Rosemary Elwell, Gavin J. Murphy, Terry Horsburgh, Susan J. Carr and Michael L. Nicholson

in Nephrology Dialysis Transplantation

Published on behalf of European Renal Association - European Dialysis and Transplant Assoc

Volume 15, issue 10, pages 1667-1672
Published in print October 2000 | ISSN: 0931-0509
Published online October 2000 | e-ISSN: 1460-2385 | DOI: http://dx.doi.org/10.1093/ndt/15.10.1667
Workload generated by a living donor programme for renal transplantation

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Background. The ethical and medical implications of live kidney donation result in a comprehensive work‐up process. The aim of this study was to determine the magnitude of the workload and the yield of renal transplants generated by a live donor programme.

Methods. Referrals to the Leicester live donor programme over the five‐year period 1994–1998 were retrospectively assessed. These were initiated by nephrology referral and subsequently investigated in a stepwise manner. Patients were counselled and baseline tests performed prior to consultant surgeon review and assessment of donor renal function/anatomy.

Results. One hundred and fifty referrals consisting of 150 recipients with 269 potential donors were originally made. This resulted in 32/120 (27%) related and 3/30 (10%) unrelated recipients (P=0.06) and 32/220 (15%) related and 3/49 (6%) unrelated donors proceeding to live donor transplantation, with a mean work‐up time (±SD) of 9 (±7) months. One hundred and fifteen recipients (77%) and 234 (87%) donors failed to proceed at various stages of assessment, for a variety of immunological, medical and social reasons. A large number of expensive immunological investigations were required for potential donors, the majority of which did not proceed to transplantation. However as a result of performing these in the early stages of assessment the number of more invasive tests is kept to a minimum.

Conclusions. There is a relatively low yield of transplants from live donor referrals, particularly those between unrelated individuals. The vast majority of referrals fail to proceed for legitimate reasons, but as a result, create a significant workload with notable staffing and financial implications.

Keywords: live organ donor; renal transplant; workload

Journal Article.  3154 words.  Illustrated.

Subjects: Nephrology

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