The Variation in Practice of the Living Donor Kidney Transplant Pathway in the UK: Results of a National Survey
Year: 2025
Type: article
Study design: Observational Study
Abstract: Living donor kidney transplantation (LDKT) accounts for 35% of kidney transplants in the UK. The Organ Donation and Transplantation 2030 initiative underscores the necessity to enhance LDKT rates to meet growing demand. There is limited data on national variations in live donor workup pathways from initial referral to long-term follow-up. We conducted an online survey across all 23 UK transplant centres performing LDKT, covering the entire living donor pathway. We aimed to explore and highlight practice variation and identify opportunities for improvement. Responses were received from 21 centres (91.3%). Marked variation was identified in donor acceptance criteria, including age limits, body mass index thresholds, and donor evaluation timelines (6-36 weeks). Differences were also noted in multidisciplinary team processes, kidney laterality decisions, and perioperative enhanced recovery protocols. All centres used laparoscopic techniques, with hand-assisted transperitoneal nephrectomy being most common (57.1%). Donor nephrectomy and implantation were conducted sequentially in 15 (71.4%) of centres, and in parallel in six (28.6%). Variation was also seen in follow-up duration with 47.6% of centres offering lifelong follow-up. Despite excellent national outcomes, this survey highlights significant variation. Standardising key processes could streamline donor pathways, improve experiences, and support increased LDKT activity in the UK.
Source: Transplant International
Authors: Katie Nightingale, Josh Stephenson, Rajesh Sivaprakasam, Tim Brown, Nicholas Inston, Ahmed Hamsho, Rommel Ravanan, Michael Nicholson, Argiris Asderakis, Sarah Browne, James Hunter, Lorna P. Marson, Katie L. Connor, Mortimer Kelleher, Andrew Sutherland, William Norton, Hannah Maple, Francis Calder, Frank J. M. F. Dor, Adam Barlow, Imeshi Wijetunga, Rachel Youngs, Stuart Falconer, Victoria Boardman, Matthew Welberry Smith, Atul Bagul, Hemant Sharma, Sanjay Mehra, Zia Moinuddin, Tunde Campbell, David van Dellen, Alistair Rogers, Lisa Burnapp, Kamran Haq, James Yates, Sanjay Sinha, Shahzar Malik, Imran Saif, Paul Gibbs, Kashuf Khan, Rafique Harvitkar, Badri Shrestha, Abbas Ghazanfar, Abul Siddiky, Reza Motallebzadeh, Michael Moneke, Kailash Bhatia, Titus Augustine
Institutions: Manchester Royal Infirmary, Manchester University NHS Foundation Trust, Barts Health NHS Trust, Royal London Hospital, Belfast Health and Social Care Trust, Belfast City Hospital, University Hospitals Birmingham NHS Foundation Trust, Queen Elizabeth Hospital Birmingham, North Bristol NHS Trust, Southmead Hospital, National Health Service, Royal Free London NHS Foundation Trust, The Royal Free Hospital, Cardiff and Vale University Health Board, University Hospital of Wales, University Hospital Coventry, University Hospitals Coventry and Warwickshire NHS Trust, NHS Lothian, Edinburgh Royal Infirmary, NHS Greater Glasgow and Clyde, Queen Elizabeth University Hospital, Guy's Hospital, Guy's and St Thomas' NHS Foundation Trust, Imperial College Healthcare NHS Trust, Hammersmith Hospital, Leeds Teaching Hospitals NHS Trust, St James's University Hospital, University of Leeds, Leicester General Hospital, University Hospitals of Leicester NHS Trust, Royal Liverpool University Hospital, Liverpool University Hospitals NHS Foundation Trust, Newcastle upon Tyne Hospitals NHS Foundation Trust, Freeman Hospital, NHS Blood and Transplant, St Peter's Hospital, Ashford and St Peter's Hospitals NHS Foundation Trust, Nottingham University Hospitals NHS Trust, Queen's Medical Centre, Churchill Hospital, Oxford University Hospitals NHS Trust, Royal Devon & Exeter NHS Foundation Trust, Royal Devon and Exeter Hospital, Royal Devon University Healthcare NHS Foundation Trust, Derriford Hospital, University Hospitals Plymouth NHS Trust, Queen Alexandra Hospital, Portsmouth Hospitals NHS Trust, Northern General Hospital, Sheffield Teaching Hospitals NHS Foundation Trust, St George's Hospital, St George’s University Hospitals NHS Foundation Trust, St George's Hospital, University of Manchester
Language: English
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,051
OpenAlex ID: W4416147303