Editorials

Renal transplantation from living donors

BMJ 1999; 318 doi: https://doi.org/10.1136/bmj.318.7181.409 (Published 13 February 1999) Cite this as: BMJ 1999;318:409

Should be seriously considered to help overcome the shortfall in organs

  1. Michael L Nicholson, Professor of surgery,
  2. J Andrew Bradley, Professor of surgery
  1. University Department of Surgery, Leicester General Hospital, Leicester LE5 4PW1
  2. University Department of Surgery, Addenbrooke's Hospital, Cambridge CB2 2QQ

    Renal transplantation has become a victim of its own success. Increasing numbers of patients are referred for transplantation, but there has been no concomitant increase in the supply of kidneys from the traditional cadaveric donor pool. On the contrary, death rates from road accidents and strokes have declined over the past 20years.1 Over 4500patients in the United Kingdom and Ireland are awaiting a kidney transplant but only a third are likely to receive one within the next year. Clearly, therefore, the full potential of renal transplantation will be realised only if other donor sources can be developed.

    Greater use of kidneys from living donors offers scope for increasing the number of kidney transplants. In the UK and Ireland kidneys from living donors account for only 5-10% of transplants compared with 30% in the United States2 and 45% in Norway.3 The geography and demographics of Norway have been important factors in the development of their living donor programme. Norway's terrain and climate mean that patients may take several hours to travel to their nearest dialysis unit. Consequently, the Norwegians have developed a …

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