Reviving Living Donor Kidney Transplantation in Australia

Area of Science:

• Nephrology
• Transplantation Immunology
• Public Health Policy

Background:

• Australia's living donor kidney transplant rate has stagnated since 2008.
• The rate has fallen to 9.5 donors per million population, significantly below international benchmarks.
• Kidney transplant waiting lists are lengthening, reaching 6-7 years for some patients due to rising kidney failure rates.

Purpose of the Study:

• To analyze the stagnation of living donor kidney transplantation in Australia.
• To identify disparities in access to living donor kidney transplants.
• To explore barriers hindering living donor kidney transplantation and propose solutions.

Main Methods:

• Analysis of national living donor kidney transplant data from 2008 to 2024.
• Examination of demographic data to identify inequalities in access.
• Review of identified barriers to living donation and transplantation.

Main Results:

• Living donor kidney transplants decreased from 354 in 2008 to 253 in 2024.
• Significant access inequalities exist for First Nations people, women, and lower socio-economic groups.
• Barriers include information gaps, limited multilingual resources, lengthy workups, and financial disincentives.

Conclusions:

• A coordinated national strategy is required to address the stagnation in living donor kidney transplantation.
• Streamlined, culturally safe pathways and improved resources are essential.
• National leadership and updated guidance can help restore growth in living donor kidney transplantation.