First pooled transplants performed in the UK

The first pooled kidney transplants, each involving three living donors and three recipients, have been performed in the UK.

Issue date: 8 March 2010

The transplants took place at the end of 2009 and the donations were approved by the Human Tissue Authority (HTA). The transplants involved a donor and recipient couple, who were known to each other but incompatible for transplantation, so were paired with two other donors and recipients in the same situation.

The first pooled transplant happened late in 2009, shortly afterwards a second pooled transplant involving three couples went ahead involving Imperial College Healthcare NHS Trust, Guy’s and St Thomas’ Hospital and NHS Lothian.

The HTA regulates living organ donation to ensure the donor is not under any pressure to donate, have given their consent freely and voluntarily and fully understands the risks involved. Each pair of donors and recipients involved remained anonymous to the other couples before the pooled transplant to help ensure that there was no coercion or pressure to take part.

Although these are the first pooled kidney transplants in the UK, paired living kidney transplants, involving two couples, are becoming more frequent: 16 paired living kidney transplants took place between 1 April 2008 and 31 March 2009.

New types of living donor transplant, such as pooled, paired or altruistic transplants (see notes to editors for explanation of terms), make up a small proportion of the total. The vast majority take place between two people who are genetically or emotionally related ­– such as parent and child, or husband and wife. This type of transplant is increasing and now represents one in three of all kidney transplants.

Vicki Chapman, Director of Policy and Strategy at the HTA, said:

“These are the first transplants of their kind to happen in the UK. The HTA has to pay particular attention to these types of donation as the issues are particularly complex when more people and more centres are involved.

“The donors and recipients involved were assessed before the transplant went ahead to check they fully understood the risks involved and the donors were not under any pressure to donate.  As with any surgery, donation of a kidney carries a risk, and HTA regulation ensures that those donating fully understand what is involved.

“Since being established in 2006, the HTA has created a regulatory framework that enables a more flexible approach to who can donate to whom and in which potential living donors can have confidence. This means that more people can benefit from a living-donor transplant enabling altruistic, paired and pooled donations to go ahead.”

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.

“Although paired transplants are becoming more common, this is the first time we have seen three couples involved in a transplant. The UK transplant community will need to get more experience of donations between two or three couples before we can consider attempting more complicated swaps. Other countries have performed transplants between larger numbers of couples, but it is worth remembering that we do not have as big a pool of donors and recipients as countries like the United States.”

END

For more information, please contact Claire Bithell, Senior Media Advisor at the Human Tissue Authority on 0207 211 3439 or claire.bithell@hta.gov.uk 

For more information about the donors and recipients involved in the second pooled transplant, please contact Caroline Weller, Communications Manager, Imperial College Healthcare NHS Trust on 020 3312 1331 or caroline.weller@imperial.nhs.uk

 Notes to editors:

• A diagram of a pooled transplant involving three couples is available to download on the left
• To protect the anonymity of those involved in the first multiple paired transplant, information including names and dates and details of transplant centers will not be made available.   
• The introduction of the Human Tissue Act in 2006 allowed more flexibility in who can donate to whom, so that more people can benefit from a living-donor transplant. The new types of transplant include:
• Altruistic donation: involves a living person who has never met the possible recipient becoming a donor
• Paired donation: a donor and recipient, for example a couple, whose blood groups or tissue types are incompatible can be paired with another donor and recipient in the same situation
• Pooled donation: similar to paired donation, but involving three or more couples
• The HTA is responsible for approving all transplants involving living people, following an independent assessment process. The process ensures that the donor and recipient have been thoroughly assessed and understand what is involved in giving and receiving an organ, and that the risks have been properly explained.
• The HTA transplant factsheet for journalists gives more information about the role of the HTA in transplantation
• A timeline giving the milestones of living donation is available for journalists
• The HTA is an independent watchdog that supports public confidence by licensing and inspecting organisations that store and use tissue for purposes such as research, patient treatment, post-mortem examination, teaching, and public exhibitions. We also give approval for organ and bone marrow transplants from living people through an independent assessment process. More information about the work of the HTA can be found on this website.