About 30% of the Living Kidney Donors (LKD) in Qatar, are immunologically incompatible with their intended recipients, according to a recent study.
The study also finds that Human Leukocyte Antigen or the blood group type (HLA/ABO) incompatibility is the most significant barrier in optimising living kidney donation in Qatar.
According to the study, protocols for desensitisation therapies for both ABO incompatible and HLA-sensitised patients are being developed to overcome this problem. Kidney Paired Donation (KPD) has emerged as an attractive option for donor-recipient pairs who are not immunologically compatible with each other.
The study 'Safe and ethical living kidney donation in Qatar: A national health system’s approach', recently appeared on Qatar Medical Journal which is part of the publications on QScience.com, an online publishing platform from Hamad Bin Khalifa University Press.
The study was conducted by three Hamad Medical Corporation (HMC) officials, Mohamed Asim, Yousuf al-Maslamani, and Hassan al-Malki.
The study suggests that establishment of a national KPD registry and perhaps a unified registry in the Gulf region will have the potential to maximise living donor transplant rates. Collaboration with international societies such as Transplantation Society, International Society of Nephrology, and European Society for Organ Transplantation would facilitate the establishment of desensitisation and KPD programmes to optimise living kidney transplantation in Qatar.
Successful implementation of these programmes will invariably require resources and expertise and in return, it will ensure that maximum number of LKDs achieve their noble ambition.
The study highlights that LKDs are a unique group of people who should be carefully and respectfully evaluated to determine their suitability for donation.
As per the study, HMC offers a culturally and linguistically tailored living kidney transplant programme that focuses on protecting the rights and best interests of the LKDs. The programme’s legal and policy framework prohibits organ commercialism while providing a safe, supportive, and compassionate environment for those who come forward.
The study also points out that incidence of dialysis therapy for end-stage renal disease in Qatar has increased from 82 per million population in 2013 to 104 in 2016. The increasing incidence of end-stage kidney disease in Qatar has led to growing demand for donor kidneys.
The deceased donor kidney programme has yet to achieve its full potential. Although many of the barriers to deceased donor transplantation related to legislation and infrastructure have been overcome, unfavourable public attitudes toward deceased organ donation still prevail, leading to desperately low consent rates for organ donation.
Hence, living kidney donation has been widely adopted as an appropriate alternative. The reliance on living kidney donors however, raises a number of social, ethical, and legal concerns surrounding informed consent, voluntarism, psychosocial evaluation, perioperative care, and long-term follow-up of the donors. Many of these concerns become heightened in a multicultural, multilingual society such as Qatar, the study says.