This article in the British Medical Journal gives us a good insight into the state of living kidney donation in Britain.
BMJ 2005;331:1042 (5 November), doi:10.1136/bmj.331.7524.1042-b
London, Kathryn Godfrey
A photographic exhibition aimed at raising awareness of kidney donation from live donors is being launched at a meeting of the British Transplant Society next week.
The photographs of donors and recipients, taken before and after donation, are accompanied by quotations from the subjects. The aim of the project is to address concerns and misconceptions that patients and families may have about living donation and to increase the uptake of this option.
Last year Susan donated a kidney to her long term partner, Richard, as life with a partner on dialysis and two children had become too difficult.
Speaking a year after the transplantation Susan said: "It’s like it never happened to my body. I feel better now than I did before. I did it not just for Richard but for me and our children, so that we could have a family life."
The interviews with the subjects of the photos show that some did not realise that you have two kidneys, that you can survive with only one kidney, and that removal of a kidney would be unlikely to affect your long term health.
Chris Rudge, medical director of UK Transplant, said that he hopes that the exhibition, which will be offered to renal centres across the UK, will raise awareness and offer a starting point for a discussion between relatives and doctors.
He said: "The problem is often how to get the process started. What can happen is that neither party says anything. The doctors are waiting for the relatives to come forward and offer. And the relatives don’t say anything as they think that if it is a good idea then the doctor will suggest it. So by default nothing happens."
Living kidney donation has principally been between relatives and close friends, but when the Human Tissue Act 2004 comes into force in April next year codes of practice will allow people to donate to someone unknown to them. Mr Rudge said that a number of willing volunteers are waiting for this change.
Rates of living donation vary across the world. In the United Kingdom 28% of people receiving a kidney transplant get them from living donors, whereas in the United States, where doctors are more blunt with patients about the need for them to find a friend or relative to donate a kidney, the rate is 50%.
Mr Rudge said ideally there should be no need for living donation in the UK because it does put the donor at some risk. But in the UK at the moment 5500 patients are on the waiting list for a kidney transplant.
He said that apart from reluctance from relatives, service shortfalls have contributed to the low number of kidneys from cadavers. "A better structure and more funding for the surgical process of removing the organs is needed. We need more funding for surgical teams and more transplant coordinators to increase the number of organs available," he said.