How UK Living Kidney Sharing Schemes mean more patients can receive life-changing transplants

This week we have a guest blog post from Lisa Burnapp, lead nurse for living donation at NHS Blood and Transplant. Here Lisa explains more about living kidney donations and how a special type of donor can really help the UK Living Kidney Sharing Schemes.

In episode six of Hospital on BBC Two, we see a young woman donate an organ to save her husband’s life. It’s wonderful that Jen was willing and able to donate her kidney and that Elliott’s life has been extended through his transplant.

In the UK, there are currently around 5,000 people in need of a kidney transplant. The average length of time they will have to wait to receive a new kidney is two and a half years. For some ethnic groups and people for whom it is difficult to find a compatible donor, the wait is even longer.

More than 1,100 people a year donate one of their kidneys. One third of all kidney transplants are from living donors. Living donation is highly successful and friends, family and strangers can all donate. But as Frank Dor, head of transplantation at Imperial College Healthcare NHS Trust explains in the documentary, many people are still not aware that you can donate a kidney while you are still alive.

However, not everyone is compatible because of their blood group or HLA (tissue) type. Jen and Elliott were not a match but they were able to donate through the UK Living Kidney Sharing Schemes (UKLKSS). The schemes provide a number of different donating options for those that require a kidney transplant, but don’t currently have a match. In their case, Jen and Elliott took part in the paired and pooled scheme, which enabled Jen to donate to a patient she didn’t know, and Elliot to receive a transplant from another donor in return. 

Around 200 to 260 pairs are in this scheme at any time. Four times a year, ‘matching runs’ are carried out to see which pairs can donate to each other, using an algorithm developed in collaboration with colleagues at the University of Glasgow. During 2015/16, eight people donated at the West London Renal Transplant Centre through the paired and pooled scheme.

There is one form of living kidney donation that is particularly helpful for the sharing schemes. This is called non-directed altruistic donation. This is where a living person, who is not in a pair, donates anonymously to someone in need of a transplant whom they do not know or have never met. 

When this form of donation was made permissible in the UK under the Human Tissue Act in 2006, there was a low expectation that people would volunteer to donate outside their family or friendship groups. Yet, in less than a decade, more than 500 people have done exactly that. 

Motivation varies but often stems from a general philosophy of life with commitment to organ, blood or bone marrow donation, or it may be triggered by a personal experience that makes the person aware of the benefit of transplantation. Non-directed altruistic donation now represents eight per cent of all living kidney donation in the UK. Last year, seven non-directed altruistic donors donated at the West London Renal Transplant Centre.

If a non-directed donor donates into the sharing schemes it can create a chain of transplants. They donate to a recipient in the paired and pooled scheme, their paired donor donates to another recipient and so on, until the chain ends with a recipient on the national transplant list. 

Non-directed donation has already been a catalyst for change within the sharing schemes and promises to remain so, allowing more patients to receive the transplant they need at the right time and with the highest chance of success.

For more information about live kidney donations please visit the NHS Organ Donation website.