For Healthcare Professionals

Overview

For people with end-stage renal disease (ESRD), kidney transplantation offers the best quantity and quality of life for those who are suitable for this. Unfortunately, despite improvements in dialysis provision, life-expectancy on maintenance dialysis therapy is limited. The risk of death from cardiovascular disease is substantially higher at every age for those on dialysis compared to the general population.

Over 1800 kidney transplants have been performed in Belfast since the late 1960s, and the number of prevalent transplant patients continues to rise – in 2014 there were over 900 people in NI with functioning kidney transplant.

In recent years an increasing number of kidneys transplanted in NI are from live donors – by mid-2014 there had been just over 350 live kidney donor operations performed, and 250 of these have been since 2009. The number of live donors per million population (pmp) per year has consistently been 30 or greater from 2010, this is approximately twice the national average (click here and go to page 4 for information), and exceeds the donor rate in virtually every other country worldwide (click here for details).

The outcomes from kidney transplantation are measured in terms of graft and patient survival. (Although in many cases death with a functioning graft can represent a huge success, it is still counted as ‘graft failure’, as is, more obviously, a return to dialysis). Overall, the outcomes from live donor transplantation (in terms of how long the kidney will work and the patient will live) are greatly superior to deceased donor outcomes. The difference in survival is due to the quality of the kidney and also the quality of the patient – a live donor transplant can be undertaken pre-emptively before the need for dialysis, thus avoiding the accumulation of co-morbidity and cardiovascular risk associated with this. Click here for further information on live v. deceased donation (Page 97 onwards).