Kidney Research UK

Pharmaceutical and kidney 'giants' working together to improve organ transplantation in the UK

Patients surviving kidney transplants are set to benefit from new research designed to improve their long-term prospects of good health and quality of life.

Transplants are one of the most miraculous achievements of modern medicine and enable almost 3,000 people to take on a new lease of life in the UK every year. Kidney transplants are the best possible treatment for most people with kidney failure, however, despite almost 1,800 kidneys being transplanted last year (2004-05) in the UK, there is a serious shortage of donors and there are currently 6,165 people awaiting a transplant of which nearly 90% need a kidney*.

Against this backdrop, improvements and developments in the management of those patients lucky enough to receive a transplant are vital and a leading UK medical research charity, The National Kidney Research Fund, has recently announced an initiative which could lead to an increase in the survival of both patient and the transplanted organ

The number of people needing a transplant is expected to rise steeply over the next decade (7% year on year) due to an ageing population, an increase in kidney failure and scientific advances resulting in more people being suitable for a transplant. In addition, a statement by the Department of Health in announcing the publication of Part Two of the National Service Framework for Renal Services, identified that up to 2.5 million people in the UK are thought to have chronic kidney disease, a significant proportion of whom could go on to experience kidney failure.

Reports in the media last Summer added to concerns by highlighting a shortage of transplant surgeons, particularly in the renal field, which experts fear if left unchecked, could lead to a crisis in transplant surgery. This in addition to the shortfall of organs for transplantation remains a pressing problem and thus it is very important that as many people as possible discuss their wishes regarding organ donation with their family and relatives and sign up for the NHS Organ Donor Register (www.uktransplant.org.uk).

In order to work towards a practical solution, The National Kidney Research Fund has used its influence to set up a unique collaborative partnership by bringing the resources of three of the UK's leading transplant companies - Astellas (formerly Yamanouchi and Fujisawa), Roche and Wyeth, together with the expertise of the major professional groups in the field - The Renal Association and British Transplantation Society. Professor Andrew Bradley, Professor of Surgery at Addenbrooke's Hospital and a Trustee of the Fund said, "The STEPP research programme is an extremely important project for the UK, which will demonstrate the use of IT-based solutions to ensure better management of patient information, promote evidence-based decision-making and improve the health and well being of patients who are transplanted, or are considering transplantation as a treatment for renal failure."

Speaking at the launch of the project, Dr James Medcalf, representing the consortium of renal transplant units which will be undertaking the research, explains "Little is known about the long-term problems that might follow a kidney transplant, particularly if the patient returns to dialysis or has another transplant. Previous studies have focused on how well each transplant works in the short term whereas this study, adopting a longer-term view, will collect detailed information on all transplant recipients in five of the major UK renal transplant centres - Leicester, London (Guy's), Oxford (Churchill), Carshalton (St Helier) and Leeds (St James')".

Gathering information from around 3,000 patients, the project will assess kidney function, health problems and medication together with patients' own reported experiences including their quality of life and health. Most importantly, the effects on patients if transplants fail will also be examined.

Department of Health estimates suggest treating people for kidney failure costs the NHS 1.1% of its total budget - around £750 million in 2002-03. Each patient on dialysis costs the NHS an average of £30,000 a year whereas a kidney transplant costs £20,000 in the first year and £6,500 a year per patient thereafter for anti-rejection drugs. Put another way, kidney transplantation leads to a cost benefit in the first year of £3,500 and £23,500 in subsequent years which over a nine-year period (the average graft survival time), is £191,000 or £21,200 per year for each year that the patient has a functioning transplanted kidney. Considering the kidney transplants performed in 2002-03, 1,775 people benefited from a kidney transplant which is now saving the NHS £37.6m in dialysis costs each year for every year that the kidney functions- hence the importance of this project.

"This collaborative project, involving The National Kidney Research Fund and three of the UK's leading transplant pharmaceutical companies is a very welcome development" says Chris Rudge, NHS UK Transplant Medical Director. "The partnership will fund research that is extremely important to our understanding of the long-term effects of a kidney transplant on the patient's health and quality of life. It will lead to improvements in the future care of many patients."

Commissioning Manager, Riminder Dosanjh had her first kidney transplant just before her fifth birthday, after her own kidneys stopped working. But 14 years later the transplanted organ also failed and had to be removed, leaving her reliant on dialysis treatment. She says, "Dialysis was dreadful after I had grown up through a perfectly normal childhood with a transplanted kidney and I had never prepared myself for my new kidney letting me down. I had been given a gift but it had been snatched away." Riminder was totally dependent on a dialysis machine for four years, waiting and hoping every day for a new kidney suitable for her, to be donated and in December 2000, she got her wish. Her health has improved ever since, and now, fully fit and working, she is also active in promoting organ donation, particularly within the Asian communities. She says, "I am particularly delighted with news of the STEPP programme which will help to look at the person as opposed to just the organ as well as the major life changes that result after transplantation. It is so important to look at someone's overall well-being and quality of life and to listen to the patient".

Charles Kernahan, Chief Executive of The National Kidney Research Fund, concluded, "A key part of income growth for the Fund is dependent on grants received from an increasing number of local and national corporates, pharmaceutical companies, charitable trusts and other funding bodies. The STEPP programme is one of a number of partnership initiatives developed by the Fund over recent years which allow us to work together with 'like-minded' organisations, in order to meet clear patient needs and improve patient treatment programmes."

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