HSE moots living kidney donor scheme

The Health Service Executive (HSE) has confirmed that it intends to consider setting up a programme to transplant kidneys to patients from living donors.

It intends to pursue discussions with consultants and management at Beaumont Hospital on the matter.

A HSE spokeswoman said a letter requesting this meeting had been received from consultants at Beaumont last month. "We are prepared to meet with the consultants and with management to discuss this matter, and we look forward to a submission from them to facilitate these discussions," she said.

Pressure from patient groups and medical professionals for a live donor programme is building because of the increasing demands on dialysis services and a rise in the numbers waiting for transplants, due to a growth in the number of people diagnosed with renal failure.

Kidney transplants have averaged 150 a year over the past decade. This is no longer enough to keep pace with the numbers on the transplant waiting list, which this year stands at 380.

The HSE confirmed that a funding request had been received from Beaumont to appoint another transplant co-ordinator. This specialist post is required to match suitable donor organs with recipients.

Although a decision will not be made on this until April, sources at Beaumont are optimistic that the post will be approved.

A further indication that momentum is gathering behind the scheme is last week's decision by the Minister for Health Mary Harney to appoint a legal expert to examine any legal issues surrounding such a programme. Ireland does not have law governing transplants, although the European Commission is working on a directive in the area.

Dr David Hickey, transplant surgeon at Beaumont Hospital, said that although Irish hospitals do well in terms of securing cadaveric donations, Ireland should be doing a higher number of kidney transplants. "Up to five years ago we were essentially meeting our needs. We had 150 people waiting for transplants and we were transplanting around 150 a year," he said.

"Today we have 380 waiting and we're still doing 150 a year. And as more nephrologists are employed around the country the number being diagnosed is going to increase exponentially, and the waiting list is going to increase."

A living donor programme could potentially offer an additional source of donor organs, as well as economic benefits, said Dr Hickey. "The dialysis is expensive. It's €75,000 a year to dialyse a patient now," he said. "A living related transplant would cost €20,000, and then €8,000 for every year after that. And most transplanted patients can go back to work. So the economics of the programme are a no-brainer.

"We estimate the set-up costs are approximately €3 million. And at 100 living donor transplants a year you could almost recoup the costs in 12 months.

"They should build this programme to keep people off dialysis," said Dr Hickey. "Such a programme would be very labour-intensive, but to get started you would need an additional transplant co-ordinator."

Chief executive of the Irish Kidney Association, Mark Murphy, said that while there had been significant investment, a 16 per cent rise last year in the number of people requiring dialysis meant that services were not keeping pace with rising demand. More than 980 people are on hospital dialysis and a further 300 are on home-based dialysis.