TY - JOUR
T1 - The Variation in Practice of the Living Donor Kidney Transplant Pathway in the UK
T2 - Results of a National Survey
AU - Nightingale, Katie
AU - Stephenson, Josh
AU - Sivaprakasam, Rajesh
AU - Brown, Tim
AU - Inston, Nicholas
AU - Hamsho, Ahmed
AU - Ravanan, Rommel
AU - Nicholson, Michael
AU - Asderakis, Argiris
AU - Browne, Sarah
AU - Hunter, James
AU - Marson, Lorna P.
AU - Connor, Katie L.
AU - Kelleher, Mortimer
AU - Sutherland, Andrew
AU - Norton, William
AU - Maple, Hannah
AU - Calder, Francis
AU - Dor, Frank J.M.F.
AU - Barlow, Adam
AU - Wijetunga, Imeshi
AU - Youngs, Rachel
AU - Falconer, Stuart
AU - Boardman, Victoria
AU - Smith, Matthew Welberry
AU - Bagul, Atul
AU - Sharma, Hemant
AU - Mehra, Sanjay
AU - Moinuddin, Zia
AU - Campbell, Tunde
AU - van Dellen, David
AU - Rogers, Alistair
AU - Burnapp, Lisa
AU - Haq, Kamran
AU - Yates, James
AU - Sinha, Sanjay
AU - Malik, Shahzar
AU - Saif, Imran
AU - Gibbs, Paul
AU - Khan, Kashuf
AU - Harvitkar, Rafique
AU - Shrestha, Badri
AU - Ghazanfar, Abbas
AU - Siddiky, Abul
AU - Motallebzadeh, Reza
AU - Moneke, Michael
AU - Bhatia, Kailash
AU - Augustine, Titus
N1 - Publisher Copyright:
Copyright © 2025 Nightingale, Stephenson, Sivaprakasam, Brown, Inston, Hamsho, Ravanan, Nicholson, Asderakis, Browne, Hunter, Marson, Connor, Kelleher, Sutherland, Norton, Maple, Calder, Dor, Barlow, Wijetunga, Youngs, Falconer, Boardman, Smith, Bagul, Sharma, Mehra, Moinuddin, Campbell, van Dellen, Rogers, Burnapp, Haq, Yates, Sinha, Malik, Saif, Gibbs, Khan, Harvitkar, Shrestha, Ghazanfar, Siddiky, Motallebzadeh, Moneke, Bhatia and Augustine.
PY - 2025/11/12
Y1 - 2025/11/12
N2 - 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.
AB - 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.
UR - https://www.scopus.com/pages/publications/105023232199
U2 - 10.3389/ti.2025.15341
DO - 10.3389/ti.2025.15341
M3 - Article
C2 - 41312225
AN - SCOPUS:105023232199
SN - 0934-0874
VL - 38
JO - Transplant International
JF - Transplant International
M1 - 15341
ER -