Kidney donation: the chance of finding a match
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What is the main topic discussed in this episode?
Thank you for downloading More or Less from the BBC. This is the version of the programme first broadcast on BBC Radio 4. Here's Tim Harford.
Hello and welcome to More or Less, the programme which dances daringly with the data that surround us in the news and in life. In this week's programme, we look at who gets more of our money, animal charities or human ones. We consider whether Britain is poorer than almost all American states. And we celebrate coincidence. The chance that there's going to be something in common somewhere... between two people is pretty good, you know, and very often remarkable, eyebrow-raising, hair-raising. But first, as you may know, More or Less always encourages loyal listeners to email in with their statistical queries. There are some requests and ideas we ignore. They're the ones from our editor, Richard Varden.
The man has a mind like a sewer, honestly. But recently, we received one email from a Varden. We were about to market a spam, and then we realised it wasn't from our editor, but from his mum, Kay Varden. Ruth, she's a lovely woman, isn't she?
She is lovely, and we definitely listen to the editor's mum, if not the editor.
We do indeed. She's a particularly loyal listener who, it turns out, had an interesting question.
My husband had problems with his kidneys and they gradually got worse and in the end they put him onto the pre-dialysis clinic and said he had... end-stage kidney failure and if he didn't have a transplant he would need to go on dialysis. They talked about all the different options about kidney transplants and I hadn't realised that there was any chance that you could do a live transplant if you weren't actually a blood relative but they said oh yes they would do tests and see if I might be a match and so then I had various tests and we were rather surprised and very pleased to find that I was a suitable match.
Well, being a numbers programme then, what can we do for you?
I want more or less to find out what are the chances of two people like myself and my husband being compatible.
Well, we will find out for you and we promise to report back. So should Kay be surprised?
Kidney transplant surgeons are busy people, but we managed to get an early morning interview over an internet line with Professor Anthony Warrens, President of the British Transplantation Society.
Well, she shouldn't be surprised because... living donation exactly like this, a spouse to the partner, and the outcome really is fantastic now. And that's because we've learned to do some manipulation of the immune system that makes it possible to do transplants that frankly wouldn't work 15 years ago. Technology and the clinical practice has improved really very significantly. There are two big things kidney transplant surgeons think about. Number one is blood group compatibility. And that used to be an absolute barrier. If people were incompatible, they just were untransplantable. we now are able to remove the antibodies that we have in our blood to cause the damage to somebody whose kidney is blood group incompatible.
And the outcome, having removed those antibodies, is pretty close to the same as if there was no blood group incompatibility. I should say it doesn't work for everybody, but it works for 75-80% of people who are blood group incompatible if we're able to remove the antibodies. The other thing is what we tend to refer to as tissue typing. And this revolves around a system of molecules called HLA. The details don't matter. This is a higher hurdle, but we've now learned with the immune suppressive drugs we've got available that we can actually, in most cases, suppress a lot of the immune response. And so the outcome is, again, close to, not the same as, but close to comparable for people who have got very well tissue-type matched kidneys.
Well, three cheers for improvements in technology and clinical practice.
Rather than asking ourselves what are the chances of a match then, the pertinent question to ask now is how successful is a transplant likely to be?
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Chapters
5 chapters
1
What is the main topic discussed in this episode?
0:00–7:21
2
What are the chances a spouse can be a live kidney donor for their partner?
7:21–14:10
3
How have blood-group incompatibility treatments increased live kidney transplant success rates?
14:10–19:51
4
What are typical kidney transplant survival rates at 1 year and 10 years?
19:51–22:18
5
How much extra life do deceased organ donors provide on average?
22:18–28:11