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UK’s First Pooled Kidney Transplants

The first pooled kidney transplants involving three donor-recipient couples where each recipient received a kidney from a donor they did not know, has successfully taken place in the UK.

The transplants took place at the end of 2009 and involved three hospitals, Hammersmith and Guy’s and St. Thomas’ in London, and the Royal Infirmary in Edinburgh.

It is now easier, since a new law was introduced in 2006, for living donors to give an organ like a kidney for transplant. However, the process is tightly regulated by an independent watchdog, the Human Tissue Authority (HTA) to ensure that donors are not under pressure to donate.

In this case, each recipient had a donor, related by marriage or a blood relative, who was willing to donate a kidney, but there was no match. So under the new law, they put themselves forward for pooled donation, and a three-way match was found.

One of the couples was a brother and a sister living in Hastings on England’s south coast. Chris Brent, 42, told the BBC that he had spent seven years on dialysis with little hope of finding a matching donor. His sister, Lisa Burton, 45, wanted to give him one of her kidneys but there was no match.

Brent said when he heard of the pooled transplant option he leapt at the chance.

Burton told the BBC that the threefold event created a “feelgood factor” all round:

“I’m absolutely delighted that Chris can have a normal life now, and all the other people can as well.”

This is how it works: couple A (eg Brent and Burton) receive a kidney from couple C and donate a kidney to couple B who donate a kidney to couple C. Thus in each couple the sick person receives a kidney, except it is from a matching donor from another couple.

The three-way transplant requires considerable planning. Three kidneys have to be removed, transported around the country, and transplanted into the recipients on the same day.

Although this is the first three-way transplant to take place in the UK, 16 two-way transplants, where only two couples are involved, have taken place between April 2008 and March 2009, the HTA said in a statement.

Vassilios Papalois, consultant renal surgeon at Hammersmith said the surgery was a complete success and hoped they could do more paired and pooled transplants:

“In the US they are already doing up to 12 pairs at once; so that’s something to aspire to,” he told the BBC.

Keith Rigg, HTA Authority Member and President of the British Transplantation Society, said:

“As a surgeon, we often see people who want to donate a kidney to a relative, partner or close friend, but they are not able to do so because of a mismatch in blood or tissue type.”

“Paired and pooled donation may offer these people a solution; they can give to another couple in the same situation for a compatible donation in return,” he added.

The HTA checks that the donors have given their consent freely and voluntarily and fully understand the risks involved. Also, the donor-recipient pairs remain anonymous to each other until the transplant takes place to ensure there is no opportunity for coercion.

There are currently 7,000 people in the UK waiting for a new kidney.



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