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Concern as the number of  living-  donor transplants in the UK


          continues to fall




         N        KF is taking the lead in expressing grave concerns at the drop in the number of living-donor

                  kidney transplants carried out in the UK over the past few years.
                  Statistics provided by NHSBT (NHS Blood and Transplant) reveal a substantial drop in
                  the number of living-donor organ transplants (the majority of which are kidneys) carried
                  out year on year. In the year 2013-14, 1147 living-donor transplants were carried out.  By
          2015-16 this number was reduced by 72 to 1075 – a 6% drop over two years.  Statistics released
          by NHSBT in April (which may
          adjust slightly over the next month
          or so) for the year 2016-17 reveal a
          further reduction in the number of
          living-donor transplants carried out
          over the past twelve months. 1036
          living-donor transplants were carried
          out in the UK in this period of time.
          This represents a drop of 3.5% on
          2015-16 statistics and a drop of
          nearly 10% on 2013-14 statistics.

          This trend runs contrary to the
          targets outlined in a National Strategy
          committing to increase the number of
          living-donor transplants year on year,      Number of actual living-donor transplants         Target number of living-donor transplants
          published and signed up to by all four      Difference
          UK governments and NHSBT.

          This bar chart shows the increasing gap between the numbers of living-donor transplants compared
          to the targets set. If this trend continues the target of 1728 living-donor transplants set for the year
          2019/2020 will not be achieved.
          These concerns were shared with the All Party Parliamentary Kidney Group (APPKG) at a meeting
          on 7th December 2016. The APPKG wrote to NHSBT, NHS England (NHSE) and the Chair of
          the Transplant 2020 Strategy Oversight Group to seek their views. In addition, NKF met with
          representatives from NHSBT, NHSE and the Chair of the Renal Services Clinical Reference Group to
          discuss the matter.

          What are the reasons for the drop in numbers?
          Possible causes are:

          •  There is unexplained variation in the number of living-donor transplants undertaken by
            transplant centres. A measure of how many transplants each of the 23 transplant centres in the
            UK carries out is based on transplants carried out per million local population (pmp). Provisional
            figures for 2015-16 presented at the Renal Transplant Services meeting in February 2017
            reveal that these range from around 8 pmp to around 36 pmp.  These figures also indicate that
            provisionally 15 of the 23 UK transplant centres are below the national average of 15.7 transplants
            pmp. While there are valid reasons for some variation, the extent of the variation remains
            unexplained.
          •  Some hospitals do not employ sufficient Living Transplant Co-ordinators: The nurses who support
            potential living donors and recipients through the process of living organ donation and transplantation
            are called Living Transplant Coordinators (LTC).  They are employed by transplant centre hospitals
            as well as hospitals which send their patients to transplant centres for surgery. Evidence is emerging
            that some hospitals do not employ sufficient LTCs to encourage and then cope with demand for living
            kidney donation.  This clearly affects the number of living-donor kidney transplants.
           4  Summer  2017   www.kidney.org.uk   HELPLINE  0845 601 02 09
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