The variation in practice of the living donor kidney transplant pathway in the UK: results of a national survey
Abstract
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.
Author
Nightingale, Katie
Stephenson, Josh
Sivaprakasam, Rajesh
Brown, Tim
Inston, Nicholas
Hamsho, Ahmed
Ravanan, Rommel
Nicholson, Michael
Asderakis, Argiris
Browne, Sarah
Hunter, James
Marson, Lorna P.
Connor, Katie L.
Kelleher, Mortimer
Sutherland, Andrew
Norton, William
Maple, Hannah
Calder, Francis
Dor, Frank J. M. F.
Barlow, Adam
Wijetunga, Imeshi
Youngs, Rachel
Falconer, Stuart
Boardman, Victoria
Smith, Matthew Welberry
Bagul, Atul
Sharma, Hemant
Mehra, Sanjay
Moinuddin, Zia
Campbell, Tunde
van Dellen, David
Rogers, Alistair
Burnapp, Lisa
Haq, Kamran
Yates, James
Sinha, Sanjay
Malik, Shahzar
Saif, Imran
Gibbs, Paul
Khan, Kashuf
Harvitkar, Rafique
Shrestha, Badri
Ghazanfar, Abbas
Siddiky, Abul
Motallebzadeh, Reza
Moneke, Michael
Bhatia, Kailash
Augustine, Titus
Stephenson, Josh
Sivaprakasam, Rajesh
Brown, Tim
Inston, Nicholas
Hamsho, Ahmed
Ravanan, Rommel
Nicholson, Michael
Asderakis, Argiris
Browne, Sarah
Hunter, James
Marson, Lorna P.
Connor, Katie L.
Kelleher, Mortimer
Sutherland, Andrew
Norton, William
Maple, Hannah
Calder, Francis
Dor, Frank J. M. F.
Barlow, Adam
Wijetunga, Imeshi
Youngs, Rachel
Falconer, Stuart
Boardman, Victoria
Smith, Matthew Welberry
Bagul, Atul
Sharma, Hemant
Mehra, Sanjay
Moinuddin, Zia
Campbell, Tunde
van Dellen, David
Rogers, Alistair
Burnapp, Lisa
Haq, Kamran
Yates, James
Sinha, Sanjay
Malik, Shahzar
Saif, Imran
Gibbs, Paul
Khan, Kashuf
Harvitkar, Rafique
Shrestha, Badri
Ghazanfar, Abbas
Siddiky, Abul
Motallebzadeh, Reza
Moneke, Michael
Bhatia, Kailash
Augustine, Titus
Date
2025-11-12
Type
Article
Subject
Kidney Transplantation, Living Donors, Perioperative Care
Collections
Citation
Nightingale K, Stephenson J, Sivaprakasam R, Brown T, Inston N, Hamsho A, Ravanan R, Nicholson M, Asderakis A, Browne S, Hunter J, Marson LP, Connor KL, Kelleher M, Sutherland A, Norton W, Maple H, Calder F, Dor FJMF, Barlow A, Wijetunga I, Youngs R, Falconer S, Boardman V, Smith MW, Bagul A, Sharma H, Mehra S, Moinuddin Z, Campbell T, van Dellen D, Rogers A, Burnapp L, Haq K, Yates J, Sinha S, Malik S, Saif I, Gibbs P, Khan K, Harvitkar R, Shrestha B, Ghazanfar A, Siddiky A, Motallebzadeh R, Moneke M, Bhatia K, Augustine T. The Variation in Practice of the Living Donor Kidney Transplant Pathway in the UK: Results of a National Survey. Transpl Int. 2025 Nov 12;38:15341. doi: 10.3389/ti.2025.15341.
Journal / Source Title
Transplant International
DOI
10.3389/ti.2025.15341
PMID
Publisher
Frontiers Media S. A.
Publisher’s URL
https://pubmed.ncbi.nlm.nih.gov/41312225/