Workload generated by a living donor programme for renal transplantation

Nephrol Dial Transplant. 2000 Oct;15(10):1667-72. doi: 10.1093/ndt/15.10.1667.


Background: The ethical and medical implications of live kidney donation result in a comprehensive work-up process. The aim of this study was to determine the magnitude of the workload and the yield of renal transplants generated by a live donor programme.

Methods: Referrals to the Leicester live donor programme over the five-year period 1994-1998 were retrospectively assessed. These were initiated by nephrology referral and subsequently investigated in a stepwise manner. Patients were counselled and baseline tests performed prior to consultant surgeon review and assessment of donor renal function/anatomy.

Results: One hundred and fifty referrals consisting of 150 recipients with 269 potential donors were originally made. This resulted in 32/120 (27%) related and 3/30 (10%) unrelated recipients (P=0.06) and 32/220 (15%) related and 3/49 (6%) unrelated donors proceeding to live donor transplantation, with a mean work-up time (+/-SD) of 9 (+/-7) months. One hundred and fifteen recipients (77%) and 234 (87%) donors failed to proceed at various stages of assessment, for a variety of immunological, medical and social reasons. A large number of expensive immunological investigations were required for potential donors, the majority of which did not proceed to transplantation. However as a result of performing these in the early stages of assessment the number of more invasive tests is kept to a minimum.

Conclusions: There is a relatively low yield of transplants from live donor referrals, particularly those between unrelated individuals. The vast majority of referrals fail to proceed for legitimate reasons, but as a result, create a significant workload with notable staffing and financial implications.

MeSH terms

  • Health Care Costs
  • Humans
  • Immunologic Tests / economics
  • Kidney Transplantation* / immunology
  • Living Donors* / statistics & numerical data
  • Patient Dropouts / statistics & numerical data
  • Referral and Consultation / statistics & numerical data
  • Retrospective Studies
  • Workload* / statistics & numerical data