Content area
Full Text
Introduction
The United Kingdom has a serious shortage of organs for transplantation, as does almost every country. The number of patients waiting for a kidney transplant has increased from 3954 at the end of 1994 to 5736 in 2005 and continues to rise by around 1.5% a year. In 2005, there were 1312 kidney transplants from 715 dead donors and 538 transplants from living donors. Waiting lists for liver and cardiothoracic organ transplants are artificially low as access is restricted to approximate the anticipated number of organs available for transplantation. At the end of 2005, 360 patients were registered for a liver transplant and 394 for a cardiothoracic transplant, and in that year there were 605 liver and 286 cardiothoracic transplants. Nevertheless, 6-11% of patients accepted for these lists die before an organ becomes available and a further 2-8% are removed from the list because their condition deteriorates and transplantation is no longer appropriate. The number of deceased heartbeating donors has remained relatively static since 1998, ranging from 644 to 739 donors a year, having fallen from a peak of 923 in 1989. 1 2 The heartbeating donor rate in 2004 was 12.3 per million population, which is one of the lowest rates in western Europe. Spain has an exceptional rate of 33.0 per million population, but many other countries in Europe have rates between 13 and 22 per million population ( table 1 ). 3
Country | Rate |
Austria | 22.2 |
Belgium | 21.3 |
Denmark | 11.9 |
Finland | 20.9 |
France | 21.0 |
Germany | 13.1 |
Greece | 6.0 |
Ireland | 16.7 |
Italy | 21.1 |
Netherlands | 8.3 |
Portugal | 22.2 |
Spain | 33.0 |
Sweden | 13.7 |
Several transplant and coordinator teams in the UK have carried out local surveys into the potential for organ donation from intensive care units, but only one systematic study has ben performed, which was carried out in 1989-90 and was restricted to England and Wales. 4 5 This estimated that in 1200-1350 patients a year death was diagnosed after brain stem tests and that half of these patients became actual organ donors. It also reported that, when approached, 30% of relatives of potential donors refused consent for organ donation, though differences in methods prevent direct comparisons with our study.
UK Transplant, now a division of NHS Blood and Transplant, was established in...