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NEW KIDNEY TRANSPLANT PLAN PUBLISHED TO WIPE OUT UK WAITING LIST

NKF, Nottinghamshire. 16 October 2006

The National Kidney Federation (NKF) and the All Party Parliamentary Kidney Group (APPKG) are calling for sweeping changes to the current organ transplant system that could double the number of kidney patients receiving transplants each year and abolish the official waiting list of 6,000.

The report ‘More Transplants, Saving More Lives’, prepared by the APPKG with the support of the NKF was launched at the NKF Annual Patients’ Conference in Warwickshire.  The report spells out a 10 point action plan (below) to address the main issues which, if implemented, would lift the UK from the bottom of the league table of transplant rates in Western Europe.

“There were about 1,800 kidney transplants in the 12 months to 31^st March 2006 in the UK. That’s five life-saving operations each day. But, just as many opportunities for life-saving organ donations are lost unnecessarily each year,” said Dr Evan Harris MP, APPKG co-chairman.  “This report identifies those missed opportunities and the steps the NHS and the government need to take so that we can try to reach our aim of doubling transplants.”

These recommendations are based on the results of discussions from an APPKG hosted summit in May 2006, at which key experts from across the transplant and renal communities identified the current problems.

According to the report, around 800 potential donor organs are lost each year from non-heart beating donors. Until recently such donors had not been considered an appropriate source of donation.

Advances in transplantation technology mean that organs from non-heart-beating donors, such as people who have died from a massive trauma, such as brain injury, or from the natural process of dying, can be transplanted just as successfully as organs from heart-beating (brain stem death) donors.

Around 50 per cent of organs from people are lost as a result of relatives refusing to permit the use of organs.¹ The provisions of the Human Tissue Act 2004 which came in to force in September 2006, state that relatives do not have a right to veto the previously expressed wishes of a donor, and should not be invited to do so.

“Despite the provisions of the Human Tissue Act we do not expect surgeons to now ignore the strongly-held wishes of relatives,” explained Tim Statham, Chief Executive of the NKF. “It is more likely that the way in which grieving relatives are approached about transplantation will change. It will be important to monitor the impact of these changes on family refusal rates.”

However, a long-hoped for increase in the availability of organs for transplant would place stresses on the capacity of surgeons and transplant centres.¹ There would need to be a significant increase in laboratory time, for testing, identification and monitoring of suitable donors and transplanted patients. More transplant coordinators are needed. As early intervention can influence the response of relatives to donation requests.¹ The UK currently has 24 transplant centres which should each have five surgeons or 120 surgeons in total,¹ whereas the actual number of surgeons is 86.

The report calls on the Government to monitor regularly the effect of legislation and policies on transplant success and acting quickly when difficulties are identified.

The report will be circulated to all MPs and made available to hospital and kidney specialists and the 40,000 kidney patients who have either been transplanted or are currently on dialysis and hoping for a transplant.

-end-

Notes to editors

APPKG Action Plan¹

1. Recognise the importance of increasing transplantations
2. Double the donation rate in the UK to match our European neighbours
3. Reduce the rates at which relatives refuse to give consent for registered donors to donate organs
4. Incentivise best practice in Intensive Care Unit (ICU) non-heart-beating donor programmes
5. Establish a national organ retrieval programme
6. Increase transplant capacity
7. Train sufficient numbers of transplant surgeons
8. Maximise the efficiency of transplant teams by cutting unnecessary bureaucracy
9. Audit transplantation in all its aspects and provide a clear strategy for enhancement of transplantation under current arrangements
10. Review the effectiveness of legislation, policies and practice on a regular basis

About the APPKG

The APPKG consists of 174 members from the Houses of Parliament and the Lords. It was established in 1997. The registered purpose is: “To improve understanding in parliament of kidney disease and transplant medicine and promote improvements in the health and care services that are available to improve the health of people with renal failure.” The NKF serves as the secretariat for the APPKG

Key Kidney Facts

Donor organs come from live donors (for example, relatives or friends who donate a kidney, or cadavers) (either those who have agreed to donate their organs after death or for whom there is no known objection).

• There were 1800 kidney transplants carried out last year¹
• There are 6000 patients on the official Kidney Transplant list. However, there are currently a further 14,000 people with end stage renal failure many of whom would benefit from a transplant¹
• 400 patients on the waiting list die each year waiting for a kidney¹
• Only around 70 out of 300 intensive care units in the UK operate a Non Heart Beating Donor programme¹
• About 50 per cent of bereaved relatives refuse the approach for organ donation¹
• A year after surgery 94% of kidneys in living donor transplants and 88% of kidneys from people who have died are still functioning well. These figures are improving all the time.