Kidney patients face 'postcode lottery' for transplants

Kidney patients needing a transplant could be facing a postcode lottery in accessing organs, research out today suggests.

A study found large variations across the UK that could not be explained by differences in the health of patients.

Some kidney patients fall off the waiting list if they become too ill for a transplant but, if their health improves, they can go back on.

The average waiting time for an adult kidney transplant is 841 days but many people die before they receive an organ.

Children, who are prioritised, wait an average of 164 days.

There are currently 6,865 adults and 111 children on the UK waiting list for a kidney transplant.

Today's study, from the UK Renal Registry and NHS Blood and Transplant (NHSBT), based in Bristol, found variations in accessing the list, the time patients had to wait to get on the list, and the time they had to wait for a transplant.

The research, published online in the British Medical Journal (BMJ), studied 16,202 dialysis patients from 65 renal centres across the UK.

Data on the patients, who were all under 65, was submitted to the renal registry between January 2003 and December 2005, with follow-up to December 2008.

The national average percentage of patients registered for a transplant within two years of starting dialysis was 50%.

But the study found this varied from about 25% in some centres to 65% in others.

The research also found 25% of patients on average received a kidney from a person who suffered a cardiac death, or from a living donor, within two years of being on the list.

But this ranged from less than 10% at some centres to above 40% in others.

This kind of transplant is "predominantly locally resourced and allocation of organs is controlled by local centres' policies", the research said.

The study also found significant variation between centres on times for inclusion on the national transplant waiting list.

Time to get on the list is important because patients who are put on earlier tend to receive a transplant quicker than those listed later on.

The study found wide variations in getting on the waiting list depending on age.

Those aged 18 to 29 were most likely to get on the list, with levels falling as patients got older.

People from ethnic minorities were also less likely to get on the list, as were those with diabetes.

While some of this variability may be explained, the authors said "significant inter-centre differences should not exist in the time taken to activate suitable patients for transplantation or in receipt of a transplant once on the waiting list".

Almost a quarter (24%) of patients nationally receive a kidney from a brain dead donor within two years of being registered, but this varied from 6% to 42%.

However, the study noted centres were not to blame for this variability as there is a national allocation policy which determines where these organs go.

There are around twice as many organ transplants from brain dead donors as cardiac death donors each year.

The study found that increasing age, ethnicity and being female negatively affected access to brain dead donors.

The experts concluded: "Significant variation in access to renal transplantation exists between centres within the UK that cannot be explained by differences in case mix.

"Further work needs to be undertaken to understand whether the observed differences in centre performance are due to variations in resource availability or because certain centres have more organised and efficient patient pathways."

James Neuberger, associate medical director of organ donation and transplantation at NHSBT, welcomed the study.

"We encourage renal centres to take note of its findings so as to help bring about further improvement in care, treatment and equity.

"NHSBT is committed to ensuring there is equity of access to transplantation of all organs, regardless of various factors such as the patient's age, gender or ethnicity, and our policies are continuously reviewed to ensure they are appropriate and up-to-date."

Mr Neuberger said there had been a 40% increase in the number of kidney transplants taking place in the UK in the past five years - up from 1,855 in 2005 to 2,599 in 2009.

But he said more needed to be done.

"There is a serious shortage of donated kidneys and other organs for transplantation which leads to around 1,000 deaths every year in the UK of people who are waiting or who become too ill and have to be removed from the list."

A Department of Health spokeswoman said: "Patients who need kidney transplants deserve a high quality service and support to help them manage their transplant and achieve the best possible quality of life, regardless of where they live.

"The number of successful kidney transplants is increasing and improvements have been made to the quality of patient care, including establishing a network of donor transplant co-ordinators and appointing clinical leads for organ donation within hospital trusts.

"But we know there is more to do. We want the NHS to use this research to help deliver better access to transplants and further improve the quality of care for kidney patients."

Arts and Entertainment
The Doctor and Clara have their first real heart to heart since he regenerated in 'Deep Breath'
TV
Life and Style
Apple showed no sign of losing its talent for product launches with the new, slightly larger iPhone 6 making headlines
techSecurity breaches and overhyped start-ups dominated a year in which very little changed (save the size of your phone)
Arts and Entertainment
Jamie Oliver
filmTV chef Jamie Oliver turned down role in The Hobbit
News
The official police photograph of Dustin Diamond taken after he was arrested in Wisconsin
peopleDownfall of the TV star charged with bar stabbing
PROMOTED VIDEO
Life and Style
ebookNow available in paperback
ebooks
ebookPart of The Independent’s new eBook series The Great Composers
Arts and Entertainment
Jeremy Clarkson, left, and Richard Hammond upset the locals in South America
tvReview: Top Gear team flee Patagonia as Christmas special reaches its climax in the style of Butch and Sundance
News
people
Sport
Ashley Barnes of Burnley scores their second goal
footballMan City vs Burnley match report
Arts and Entertainment
Peter Mayhew as Chewbacca alongside Harrison Ford's Han Solo in 'Star Wars'
film
News
i100
Arts and Entertainment
Man of action: Christian Bale stars in Exodus: Gods and Kings
film
Arts and Entertainment
Tracy Emin's 1998 piece 'My Bed' on display at Christie's
artOne expert claims she did not
News
Ernesto Che Guevara and Fidel Castro, right, met at Havana Golf Club in 1962 to mock the game
newsFidel Castro ridiculed the game – but now investment in leisure resort projects is welcome
News
Hackers revealed Oscar-winning actress Lawrence was paid less than her male co-stars in American Hustle
people
Arts and Entertainment
Clueless? Locked-door mysteries are the ultimate manifestation of the cerebral detective story
booksAs a new collection of the genre’s best is published, its editor explains the rules of engagement
Sport
Robin van Persie is blocked by Hugo Lloris
footballTottenham vs Manchester United match report
Latest stories from i100
Have you tried new the Independent Digital Edition apps?

ES Rentals

    Independent Dating
    and  

    By clicking 'Search' you
    are agreeing to our
    Terms of Use.

    iJobs Job Widget
    iJobs General

    Recruitment Genius: Business Manager

    £32000 - £40000 per annum: Recruitment Genius: A Business Manager is required ...

    Recruitment Genius: Operations Manager

    £45000 - £55000 per annum: Recruitment Genius: This is an exciting opportunity...

    Recruitment Genius: Panel & Cabinet Wireman

    £20000 per annum: Recruitment Genius: Panel Wireman required for small electro...

    Recruitment Genius: Electronics Test Engineer

    £25000 - £27000 per annum: Recruitment Genius: An SME based in East Cheshire, ...

    Day In a Page

    A timely reminder of the bloody anniversary we all forgot

    A timely reminder of the bloody anniversary we all forgot

    Who remembers that this week we enter the 150th anniversary year of the end of the American Civil War, asks Robert Fisk
    Homeless Veterans appeal: Former soldiers pay their respects to a friend who also served

    Homeless Veterans appeal

    Former soldiers pay their respects to a friend who also served
    Downfall of Dustin 'Screech' Diamond, the 'Saved By The Bell' star charged with bar stabbing

    Scarred by the bell

    The downfall of the TV star charged with bar stabbing
    Why 2014 was a year of technological let-downs

    Why 2014 was a year of technological let-downs

    Security breaches and overhyped start-ups dominated a year in which very little changed (save the size of your phone)
    Cuba's golf revolution: But will the revolutionary nation take 'bourgeois' game to its heart?

    Will revolutionary Cuba take 'bourgeois' golf to its heart?

    Fidel Castro ridiculed the game – but now investment in leisure resort projects is welcome
    The Locked Room Mysteries: As a new collection of the genre’s best is published, its editor Otto Penzler explains the rules of engagement

    The Locked Room Mysteries

    As a new collection of the genre’s best is published, its editor explains the rules of engagement
    Amy Adams on playing painter Margaret Keane in Tim Burton's Big Eyes

    How I made myself Keane

    Amy Adams hadn’t wanted to take the role of artist Margaret Keane, because she’d had enough of playing victims. But then she had a daughter, and saw the painter in a new light
    Ed Richards: Parting view of Ofcom chief. . . we hate jokes on the disabled

    Parting view of Ofcom chief... we hate jokes on the disabled

    Bad language once got TV viewers irate, inciting calls to broadcasting switchboards. But now there is a worse offender, says retiring head of the media watchdog, Ed Richards
    A look back at fashion in 2014: Wear in review

    Wear in review

    A look back at fashion in 2014
    Ian Herbert: My 10 hopes for sport in 2015. Might just one of them happen?

    Ian Herbert: My 10 hopes for sport in 2015

    Might just one of them happen?
    War with Isis: The West needs more than a White Knight

    The West needs more than a White Knight

    Despite billions spent on weapons, the US has not been able to counter Isis's gruesome tactics, says Patrick Cockburn
    Return to Helmand: Private Davey Graham recalls the day he was shot by the Taliban

    'The day I was shot by the Taliban'

    Private Davey Graham was shot five times during an ambush in 2007 - it was the first, controversial photograph to show the dangers our soldiers faced in Helmand province
    Revealed: the best and worst airlines for delays

    Revealed: the best and worst airlines for delays

    Many flyers are failing to claim compensation to which they are entitled, a new survey has found
    The stories that defined 2014: From the Scottish independence referendum to the Ice Bucket Challenge, our writers voice their opinions

    The stories that defined 2014

    From the Scottish independence referendum to the Ice Bucket Challenge, our writers voice their opinions
    Stoke-on-Trent becomes first British city to be classified as 'disaster resilient' by the United Nations

    Disaster looming? Now you know where to head...

    Which British city has become the first to be awarded special 'resilience' status by the UN?