Organ donation can be a difficult subject, it’s something many of us find hard to talk about and often know little about. In doing so, we’re missing out on some of the most exciting progress being made to save lives across the world.
Over the years, I have called for an opt-out system to be the default position for organ donation globally. In the UK, I’m thrilled that Wales has already implemented it and from spring next year, this will be the case in England too. To learn more about the new law, take a look at the new NHS campaign ‘Pass It On’.
While the new system will undoubtedly help save many lives, there’s still a lot more work to be done. There are around 5,000 people in need of a kidney transplant in the UK, and hundreds of patients die waiting for a transplant each year due to a shortage of donors.
That’s where living donation comes in – for those suffering from kidney disease, a transplant from a living donor is a much better option than a deceased donation. People who receive a kidney from a living donor usually live longer than those who receive one from a deceased donor and their statistical life expectancy is far longer than if they did not receive a kidney transplant at all.
Unfortunately, living donation isn’t always straightforward. Depending on the country, 40% or more of recipients are incompatible with their intended donors. In some places, that means potential donors are simply turned away, forcing those in desperate need of a transplant to wait until another compatible donor turns up.
You don’t have to know much about the organ donation system to realise that doesn’t make much sense. That’s why I was interested to learn about Kidney Exchange Programs (KEPs). KEPs increase the number of transplants by pooling and matching pairs of donors and recipients.
The matching process allows one previously incompatible donor-recipient pair, say a kidney patient and a family member willing to donate, to be matched with another pair. Under a KEP, donors are then swapped, resulting in two new compatible pairs. It can sound a little complicated but this video provides a clear explanation.
I was pleased to learn that the UK Living Kidney Sharing Scheme (UKLKSS) has become the largest operating KEP in Europe, allowing pairs to match in two and three-way swaps.
Perhaps the most remarkable aspect of the programme is what it means for ‘non-directed altruistic kidney donors’. These are people who volunteer to donate a kidney to someone they don’t know. Under the UK KEP, a donation from one individual into the pool could allow a chain of up to three transplants to take place.
In March, UKLKSS marked World Kidney Day with their 1000th transplant, which was part of a chain of three kidney transplants that took place simultaneously. It’s astonishing to think there are people out there willing to donate a kidney to someone they don’t know - it’s a truly heroic act.
What many people don’t know is that donating a kidney doesn’t increase the risk of developing kidney disease. A healthy person can continue to lead a normal life with only one functioning kidney and studies have shown that a kidney donor’s life expectancy isn’t any lower than that of the general public.
The unfortunate news is that most countries don’t have schemes like this. The UK is one of only three countries in Europe running an advanced KEP program, with other countries that do have schemes limiting them by only allowing two-way exchanges or by prohibiting altruistic donors.
It’s barriers like these that mean countries are missing out on saving thousands of lives. I urge policy makers in countries without KEPs to learn more about the programmes and consider the difference they could make.
If more countries developed KEPs, just imagine what this could mean in the future. Through greater international cooperation, kidneys could be exchanged between countries meaning the lives of even the hardest-to-match patients could be saved.Fortunately, it is thanks to the fantastic work of organisations like the European Network for Collaboration on Kidney Exchange Programmes (ENCKEP), that some of this research is already being done.
ENCKEP brings together clinicians, economists, and policy makers to explore the legislative, medical, financial and ethical issues that surround greater collaboration on KEPs. Their latest report provides an overview of their work to date.
For those of us who know someone in need of an organ, it can be heartbreaking. That’s why learning about progress like this can be so inspiring.
Visit the UK organ donation website to learn more about becoming a living donor.