Last year, circulatory donation after death (DCD) accounted for 28% of deceased donor kidney transplants, the highest level ever recorded.
According to the National Kidney Transplant Service (NKTS) 2023 Annual Report, the utilization of kidneys from DCD donors and older donors with comorbidities ('expanded criteria' donors) is increasing. The average age of recipients is also rising.
“Although transplant outcomes for patients receiving such transplants remain excellent, this necessary evolution in organ utilization patterns comes at a cost,” the report states.
In 2023, kidney transplants have experienced a “significant increase in medical complexity.” For some organ recipients, this has resulted in longer hospital stays, higher rates of delayed graft function, and higher readmission rates. It also included expanded access to intensive care beds and support services such as national histocompatibility and immunogenetics services for solid organ transplantation and interventional radiology.
The report highlighted the need for “continued investment in transplant infrastructure” as these trends in organ utilization continue.
In 2023, NKTS at Beaumont Hospital in Dublin carried out 189 kidney transplants, just below the highest number ever recorded in a single year (192 in 2011). Of these, 30 were from living donors and 159 from deceased donors. The report paid tribute to the families of deceased donors and the amazing generosity of living donors.
During the year, 198 new patients were placed on the kidney transplant list, an increase of 6% over the previous year.
“The global shortage of organs relative to the number of patients waiting for kidney transplants remains an ongoing challenge,” the report said. “To meaningfully address organ shortages, we need to increase awareness of living donor transplants, increase the resources highlighted above to make more marginal organs available, and increase the resources highlighted above to ensure transplant suitability at the time of organ donation. All of this will require aggressive transplant waiting list management.”
The overall kidney transplant rate (PMP) per million population for Ireland in 2021 was 27. By comparison, the European average PMP was 36. European Kidney Association Registration Annual Report 2021.
The countries with the highest kidney transplant rates were Spain (62 PMP), Northern Ireland (56 PMP), the Netherlands (51 PMP) and Scotland (49 PMP).
Earlier this year, Minister for Health Stephen Donnelly announced €1.6 million in new development funding to support the “early stages” of HSE Organ Donation and Transplant Ireland’s 2024-2026 strategic plan.
The HSE says the plan sets out the services needed over the next 10 years.
