TY - JOUR T1 - Living donor kidney transplantation: often a missed opportunity JF - British Journal of General Practice JO - Br J Gen Pract SP - 428 LP - 429 DO - 10.3399/bjgp19X705173 VL - 69 IS - 686 AU - Videha Sharma AU - Angela Summers AU - Michael Picton AU - John Ainsworth AU - David Van Dellen AU - Roger Jones AU - Titus Augustine Y1 - 2019/09/01 UR - http://bjgp.org/content/69/686/428.abstract N2 - Kidney transplantation is the only treatment that provides a sustained cure for end stage renal failure (ESRF) and should be the treatment of choice for all eligible patients.1 Dialysis is the alternative renal replacement therapy, but is associated with significant morbidity and increased mortality.2 It also considerably impacts on patients’ quality of life and carries a greater psychological and financial burden. Transplantation therefore provides significant survival benefit and improved health quality parameters.3 There are currently >5000 patients on the kidney transplant waiting list in the UK and the median waiting time for a kidney is just under 3 years.4 This results in patients being established on dialysis for some time prior to transplantation. Pre-emptive transplantation, prior to the requirement for dialysis, provides improved outcomes, and time on dialysis is therefore a potential modifiable risk factor to improve renal transplant outcomes.5Living Donor Kidney Transplantation (LDKT) is a key treatment option for ESRF and currently comprises 28% of overall renal transplant activity in the UK.4 It offers the best outcomes in terms of patient and graft survival, particularly if performed pre-emptively. The rising prevalence of chronic kidney disease (CKD) mandates increased focus on strategies to improve uptake to reduce both the overall burden of disease and cost associated with dialysis.6 The latest annual report by NHS Blood and Transplant (NHSBT) on LDKT shows that the number of living donor transplants in the UK has plateaued over the last 8 consecutive years.7 In addition, there is a significant variation in access to LDKT across different regions of the UK, with eight transplants per million population in Bristol and Leeds compared to 36 transplants per million population in Belfast.7 There appear to be challenges to increase and standardise LDKT activity in the UK and … ER -