Workload generated by a living donor programme for renal transplantation.
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One hundred and fifty referrals consisting of 150 recipients with 269 potential donors were originally made.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.
Saunders
R N
RN
Leicester General Hospital, Leicester, UK.
Elwell
R
R
Murphy
G J
GJ
Horsburgh
T
T
Carr
S J
SJ
Nicholson
M L
ML
D017048:Health Care Costs; D006801:Humans; D007159:Immunologic Tests / Q000191:economics; D016030:Kidney Transplantation / Q000276:immunology; D019520:Living Donors / Q000706:statistics & numerical data; D010352:Patient Dropouts / Q000706:statistics & numerical data; D012017:Referral and Consultation / Q000706:statistics & numerical data; D012189:Retrospective Studies; D016526:Workload / Q000706:statistics & numerical data