Memorandum by Professor Gurch Randhawa
Gurch is Professor of Diversity in Public Health
at the University of Bedfordshire. He has spent many years researching
issues relating to diabetes, kidney disease and transplantation
amongst minority ethnic groups. He pioneered research in the UK
examining cultural and religious influences toward organ donation
amongst South Asian groups, with a grant from the King's Fund.
This research has been pivotal to the Department of Health South
Asian and African Caribbean organ donor campaigns. He is currently
a member of the Department of Health's Organ Donation Taskforce
commissioned by the Minister of State for Health Services. He
is a recipient of numerous grants from organisations such as the
Department of Health, Kidney Research UK, Big Lottery Fund, and
King's Fund. Professor Randhawa has presented an earlier draft
of this submission to the European Platform on Ethical, Legal
and Psychosocial Aspects of Organ Transplantation (ELPAT) at its
conference 1-4 April 2007, at which there is concensus that the
recommendations made within the paper need to be addressed at
European level as well as UK level.
1. INTRODUCTION
1.1 I have written and researched extensively
on the different organ procurement systems operating within the
EU and how public awareness concerning organ donation may be raised
(Randhawa, 1999). My European-wide analyses demonstrates that
where co-operation exists between countries in sharing organs,
there is a more efficient use of scarce transplant resources (Randhawa,
1998a). I will, however, for the purposes of this submission focus
on the salient issues relating to faith and ethnicity within the
UK.
2. BACKGROUND
2.1 South Asians (those originating from
the Indian subcontinent) and African-Caribbean communities have
a high prevalence of Type 2 diabetes: recent studies indicate
a prevalence rate four times greater than Whites. It has been
reported that 20% of South Asians aged 40-49 have Type 2 diabetes,
and by the age of 65 the proportion rises to a third (Raleigh,
1997). A further complication is that diabetic nephropathy is
the major cause of end stage renal failure [ESRF] in South Asian
and African-Caribbean patients receiving renal replacement therapy
[RRT], either by dialysis or transplantation. Nationally, this
higher relative risk, when corrected for age and sex, has been
calculated in England as 4.2 for the South Asian community and
3.7 for those with an African-Caribbean background (Roderick et
al, 1996). Data from Leicester, shows that South Asians with diabetes
are at 13 times the risk of developing ESRF compared to "White"
Caucasians (Burden et al, 1992). Thus, not only are South Asians
and African-Caribbeans more prone to diabetes than Whites, they
are more likely to develop ESRF as a consequence.
2.2 Importantly, the South Asian and African-Caribbean
populations in the UK are relatively young compared to the White
population. Since the prevalence of ESRF increases with age, this
has major implications for the future need for RRT and highlights
the urgent need for preventive measures (Randhawa, 1998a). The
incidence of ESRF has significant consequences for both local
and national NHS resources. The National Renal Review estimated
an increase over the next decade of 80% in the 20,000 or so patients
receiving RRT and a doubling of the current cost, about £600
million a year of providing renal services (Raleigh, 1997).
2.3 Kidney transplantation is the preferred
mode of RRT for patients with end-stage renal failure. There are
currently over 5,500 people on the transplant waiting list in
the UK—the majority waiting for kidney transplants, but
substantial numbers also waiting for heart, lung, and liver transplants.
However, a closer examination of the national waiting list reveals
that some minority ethnic groups are greater represented than
others. For example:
— one in five people waiting for a
transplant is from the African-Caribbean or South Asian communities
(table 1).
— 14% of people waiting for a kidney
transplant are South Asian and over 7% are African-Caribbean (table
2) even though they compromise only 4% and 2% respectively of
the general population.
— one in nearly 10 of all cornea transplants
carried out in the UK help a South Asian person gain their sight
again (table 3). South Asians require a cornea transplant for
keratoconus at a younger age (under 30) than white people (table
3).
— South Asian people are also more
likely to need a liver transplant. While 4% of the UK population
are South Asian, Asian people comprise 6% of the liver transplant
list (table 4). This is because viral hepatitis—Hepatitis
B & C—that can lead to liver damage and liver failure
is more prevalent in the South Asian population.
— Just 1% of people registered on the
Organ Donor Register are South Asian and 0.3% of people registered
are African-Caribbean (table 5).
— 1.2% of people who donate kidneys
after their death are South Asian and 0.7% are African-Caribbean
(table 6).
— South Asian and African-Caribbean
people have to wait on average twice as long as a white person
for a kidney transplant. White patients wait on average 722 days,
Asian patients wait 1496 days and Black people wait 1389 days
(table 7).
— one in eight people who died waiting
for a transplant in 2006 was of African-Caribbean or South Asian
origin (table 8).
2.4 The situation is clear, there is an
urgent need to address the number of African-Caribbean and South
Asian patients requiring a kidney transplant otherwise the human
and economic costs will be very severe. In the short term, there
needs to be a greater number of donors coming forward from these
communities to increase the pool of suitable organs (Randhawa,
1998b; Exley et al, 1996a). In the long term, there needs to be
greater attention on preventive strategies to reduce the number
of African-Caribbeans and South Asians requiring RRT. The latter
can only be achieved if we begin to address the problem of poor
access to services for minority ethnic groups (Randhawa, 2003).
3. IMPROVING
ACCESS TO
SERVICES
3.1 The Diabetes National Service Framework
highlights the importance of access to services, in particular
to meet the needs of minority ethnic groups (DoH, 2002b). The
Renal Services NSF also focuses on "renal disease complicating
diabetes" and emphasises inequalities experienced by minority
ethnic groups (DoH, 2004). However, there is evidence that knowledge
of diabetes and its complications is poor among South Asians and
African-Carribeans (Nazroo, 1997; Johnson et al, 2000). Preliminary
evidence also suggests that quality of health care for South Asians
and African-Caribbeans is inadequate and compliance poor (Johnson
et al, 2000; Raleigh, 1997). There is also a low-uptake of hospital-based
diabetes services, with growing evidence that South Asians are
subsequently referred later for renal care, and are more likely
to be lost to follow-up (Jeffrey et al, 2002). Late referral may
reduce opportunities to implement measures to slow progression
of renal failure, or to prepare adequately for RRT, adding to
morbidity and mortality.
3.2 The World Health Organisation (WHO)
study group on diabetes notes that resources should be directed
to improving the quality of preventive care in primary care settings
and to public health interventions for controlling diabetes. Education,
early diagnosis, and effective management of diabetes is important
for safeguarding the health of susceptible populations and for
long term savings for the NHS (Raleigh, 1997). Most encouragingly,
recent studies from the US and Finland have demonstrated that
modest lifestyle changes can reduce the risk, by more than 58%,
of developing overt Type 2 diabetes in susceptible groups (DPPRG,
2002; Tuomilehto et al, 2001). Furthermore, various interventions,
such as tight blood pressure control, effective use of angiotensin
converting enzyme (ACE) inhibitors or angiotensin receptor (ATR)
blockers, and tight blood sugar control can significantly delay
the progression of diabetic nephropathy (UKPDS, 1998; Feest et
al, 1999; Brenner et al, 2001; Cinotti & Zucchelli, 2001;
Lewis et al, 2001; Lightstone et al, 2001).
3.3 RECOMMENDATION
1: "REDUCING INEQUALITIES"
IS A
CROSS-CUTTING
THEME IN
A NUMBER
OF UK GOVERNMENT
HEALTH POLICY
WORKING GROUPS—DIABETES
NSF, RENAL NSF, CHD NSF, AND
THE ORGAN
DONATION TASKFORCE.
THERE SHOULD
BE ACTIVE
COLLABORATION BETWEEN
THE RESPECTIVE
NSF "CZARS" TO ENSURE
THE BEST
USE OF
RESOURCES SO
THAT FUTURE
RATES OF
RENAL FAILURE
AND HEART
FAILURE ARE
REDUCED AMONG
BLACK AND
MINORITY ETHNIC
GROUPS
4. IMPROVING
TRANSPLANTATION RATES
4.1 Unfortunately, the transplant option
may be medically and economically favourable but in reality is
not as forthcoming due to constraints around the severe lack of
donors from the African-Caribbean and South Asian population.
This could be attributed to two main reasons—a lack of awareness
concerning organ donation and transplantation; and potentially
low referral rates to the Intensive Care Unit (Exley et al, 1996a;
Darr & Randhawa, 1999). It must be stressed that these factors
are not unique to the African-Caribbean and South Asian population
and have relevance to other members of the UK's public. Furthermore,
it is extremely important to recognise that the African-Caribbean
and South Asian communities in the UK are heterogenous and thus
it is important to familiarise oneself with the demographics of
the local population (Khan & Randhawa, 1999).
4.2 Increasing awareness of the need for organ
donors among the African-Caribbean and South Asian communities
4.3 Unfortunately, very little research
has been devoted to this area. The relatively few studies which
have been carried out, consistently show that African-Caribbeans
and South Asians are supportive of organ donation and transplantation,
but are simply not aware of the specific needs for organs from
their community (Exley et al, 1996a; Darr & Randhawa, 1999;
Hayward & Madhill, 2003; Alkhawari et al, 2005; Davis &
Randhawa, 2006; Morgan et al, 2006). These studies, however, do
not identify what would motivate these communities to come forward
as potential organ donors. Pertinently, Titmuss (1973) famously
viewed the NHS which had been created in the post-war period as
a vehicle for institutionalising altruistic practices, notably
the voluntary "gift" of blood to strangers represented
by the transfusion service. More recent advances in medical technology
have made new forms of bodily tissue donation possible, including
organs, gametes, eggs, stem cells, embryos, etc. The limitation
of Titmuss's analyses was an implicit assumption that all individuals
would feel a belonging to "society" and would therefore
wish to contribute to a "societal problem".
4.4 Within the main South Asian religions
namely, Hinduism, Sikhism and Islam, the concept of gifting to
assist society is a highly-valued virtue, "Sewa", "Sewa",
and "Zakat" respectively. This issue needs careful examination
within the context of an increasingly diverse UK population.
4.5 RECOMMENDATION
2: RESEARCH IS
REQUIRED TO
IDENTIFY WHAT
WOULD MAKE
THE "GIFTING
OF ORGANS"
RELEVANT TO
A MULTI-ETHNIC
& MULTI-FAITH
UK SOCIETY
4.6 A growing amount of literature has shown
that the role of religion has been known to play an important
part in the decision to donate organs (Randhawa, 1998c; Hayward
& Madhill, 2003; Alkhawari et al, 2005; Davis & Randhawa,
2006). The religious beliefs of the major faiths of the UK's African-Caribbeans
and South Asians namely Islam, Hinduism, Sikhism, Buddhism, and
Christianity have been scrutinised in the literature. None of
the religions object to organ donation in principle although in
some there are varying schools of thought. What is interesting,
however, is that the position of one's religion is used by many
people in informing their decision as to whether to donate or
not (Randhawa, 1998c). This has been highlighted in several studies
conducted abroad (Callender, 1989; Kyriakides et al, 1993; Spina
et al, 1993). Unfortunately, this issue has not been prominent
in research carried out in the UK but the findings of a pilot
study to examine the attitudes towards organ donation and transplantation
among a cross-section of the UK's South Asian population have
shed some light on the matter (Randhawa, 1998c). It was found
that far from being a barrier to organ donation, the respondents
were more supportive of donation and, transplantation, in general,
when they were aware of the position of their religion with regards
to these issues. This highlights the importance of education and
raising awareness among the South Asian public (Exley et al, 1996a;
Darr & Randhawa, 1999).
4.7 In recent years, the Department of Health
and UK Transplant have produced a range of educational material
(including leaflets, posters, and videos) in the main South Asian
languages to increase awareness of transplant related issues.
Additionally, materials have been produced that set out the position
of each religion regarding organ donation. However, current evidence
shows that further thought is required to the dissemination of
this literature among African-Caribbean and South Asian populations
Unit (Exley et al, 1996a; Randhawa, 1998c; Darr & Randhawa,
1999). Namely, care needs to be taken in specifying the target
population, selecting the persons who will communicate the campaign
appeal, designating the methodology of appeal delivery, and deciding
upon the content of the appeal. There are indications from pilot
work in the UK and research overseas involving minority ethnic
groups, that appeals for African-Caribbean and South Asian donors
may be more effectively communicated by employing a grassroots,
community networking approach Unit (Exley et al, 1996a; Darr &
Randhawa, 1999; Khan & Randhawa, 1999).
4.8 RECOMMENDATION
3: THERE IS
A NEED
TO IDENTIFY
HOW BEST
TO ENGAGE
LOCAL RELIGIOUS
"STAKEHOLDERS" WITH
AGREED RELIGIOUS
OPINION
4.9 RECOMMENDATION
4: FURTHERMORE, THERE
IS A
NEED TO
IDENTIFY HOW
BEST TO
ENCOURAGE RELIGIOUS
"STAKEHOLDERS" TO
ENGAGE WITH
THEIR LOCAL
COMMUNITY CONCERNING
THE ISSUE
OF ORGAN
DONATION & TRANSPLANTATION
4.10 Low referral rates to the Intensive Care
Unit (ICU)
4.11 The vast majority of organs are procured
from ventilated patients in the ICU who have suffered some form
of cerebrovascular accident (Gore et al, 1992; Randhawa, 1997).
Thus, an important point to consider is whether African-Caribbean
and South Asian patients are reaching the ICU so that the may
be considered to be potential donors. It may be that the African-Caribbean
and South Asian population are simply not dying of the relevant
cause or being referred to the ICU rather than an unwillingness
to become donors (Exley et al, 1996b).
4.12 Again, there is very little research
in this area. Gore et al (1992) carried out a comprehensive audit
of all ICU deaths in the UK and the suitability to become organ
donors. However, the main drawback to this study was that the
ethnic group of patients was not recorded. A pilot study in Coventry
was carried out which sought to determine admission rates of South
Asian and non-South Asian patients to ICUs (Exley et al, 1996b).
The results indicate that South Asians were less than half as
likely to be admitted to an ICU than non-South Asians. These findings
have serious implications, as it indicates that there are less
instances where the health professional has an opportunity for
making a request for organs from South Asian families. Another
important finding of this study was that the rates of referral
from the ICU to the transplant unit were the same for South Asians
and non-South Asians, as were subsequent donation rates (Exley
et al, 1996b) Thus, the results of this preliminary study suggest
that lower rates of organ donation among the South Asian population
are related to the initial low admission rates to the ICU. Related
to this, there is preliminary evidence emerging to suggest that
the number of brain-stem deaths are lower among minority ethnic
groups. It is acknowledged that the more recent work of the UK
Transplant led Potential Donor Audit may have begun to address
these issues. However, presently there is no firm evidence to
support the view that access to ICUs is equitable across all ethnic
groups.
4.13 RECOMMENDATION
5: IDENTIFY WHETHER
BLACK & MINORITY
ETHNIC GROUPS
HAVE THE
SAME LIKELIHOOD
TO BECOME
POTENTIAL ORGAN
DONORS AS
THEIR "WHITE"
COUNTERPARTS
4.14 The Potential Donor Audit has highlighted
the fact that families and friends of African-Caribbean and South-Asian
potential donors are more likely to withold consent for donation
to take place than for white donors. Indeed, the refusal rate
for non-white potential donors is 69%, compared with 35% for white
potential donors. UK Transplant have previously commissioned research
to identify why families refuse a request for organ donation.
However, this research did not include non-white families.
4.15 RECOMMENDATION
6: COMMISSION RESEARCH
TO UNDERSTAND
WHY NON-WHITE
FAMILIES HAVE
A HIGHER
REFUSAL RATE
THAN WHITE
FAMILIES
5. LOOKING TO
THE FUTURE
5.1 There has been substantial recognition
of the need to improve organ donation rates among minority ethnic
groups in the UK as evidenced by the plethora of initiatives led
by UK Transplant (table 9). Many of these initiatives are recognised
to be at the forefront worldwide in the development of culturally-competent
organ donation education materials. However, the success of these
initiatives has been limited by the lack of a focussed strategy
that brings together the various strands of a multi-faceted problem
that would lead to a coherent implementation plan. It is hoped
that this submission contributes to beginning and shaping this
process not only in the UK but for many other countries also who
have a multi-ethnic and multi-faith society.
5.2 On a final note, it is worth noting
that debates concerning organ donation and ethnicity are relatively
new and are limited by the quality of data available not just
in the UK but also worldwide. In future, it is imperative that
data is collected on a wide range of variables including age,
ethnicity, social class, gender, and religion. The potential interaction
of these variables will be an important area of research in future
to identify potential organ donors.
5.3 RECOMMENDATION
7: DONOR DATA
AND ORGAN
DONOR REGISTER
DATA SHOULD
COLLECT AGE,
ETHNICITY, SOCIAL
CLASS, GENDER,
AND RELIGION.
THE POTENTIAL
INTERACTION OF
THESE VARIABLES
SHOULD BE
ANALYSED TO
INFORM FUTURE
STRATEGIES
5.4 It is only when these issues are addressed
adequately will we begin to see a transplant service that truly
meet the needs of a multi-ethnic and multi-faith population within
the UK.
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TABLE 1
PATIENTS LISTED (ACTIVE OR SUSPENDED) FOR
AN ORGAN TRANSPLANT IN THE UK AS AT 1 JANUARY 2007, BY ETHNIC
ORIGIN OR ORGAN
|
Organ awaited
Ethnic origin
| kidney |
pancreas |
kidney/ pancreas
| heart |
lung(s) | heart/lungs
| liver |
TOTAL |
| # | %
| # | %
| # | %
| # | %
| # | % | # |
% | # | % | #
| % |
|
| White | 5,999
| 75.6 | 91
| 93.8 | 197
| 92.9 | 78
| 88.6 | 254 |
92.0 | 33 | 89.2 |
287 | 86.2 | 6,939
| 77.3 |
| Asian | 1,120
| 14.1 | 2
| 2.1 | 12
| 5.7 | 6
| 6.8 | 11 |
4.0 | 4 | 10.8 |
20 | 6.0 | 1,175 |
13.1 |
| Black | 601 |
7.6 | 3
| 3.1 | 1
| 0.5 | 4
| 4.5 | 7 |
2.5 | 0 | 0.0 |
8 | 2.4 | 624 |
6.9 |
| Chinese | 81
| 1.0 | 0
| 0.0 | 1
| 0.5 | 0
| 0.0 | 0 |
0.0 | 0 | 0.0 |
1 | 0.3 | 83 | 0.9
|
| Mixed | 12 |
0.2 | 0
| 0.0 | 0
| 0.0 | 0
| 0.0 | 2 |
0.7 | 0 | 0.0 |
0 | 0.0 | 14 | 0.2
|
| Other | 123 |
1.5 | 1
| 1.0 | 1
| 0.5 | 0
| 0.0 | 2 |
0.7 | 0 | 0.0 |
17 | 5.1 | 144 |
1.6 |
| not reported | 9
| — | 0
| — | 1
| — | 0
| — | 0
| — | 0 | —
| 0 | — | 10
| — |
| TOTAL | 7,945
| | 97 |
| 213 | |
88 | | 276
| | 37 | |
333 | | 8,989 |
|
|
| Source: UK Transplant, 2007 |
TABLE 2
% REGISTERED (INC SUSPENDED) ON LIST FOR A KIDNEY (INC
KID/PAN) TRANSPLANT IN UK AS AT 31 DECEMBER 2006, BY AGE DECADE
AND ETHNIC ORIGIN
|
| age (ys) | White
| Asian | Black
| Chinese | Mixed
| Other | not rec
| Total |
|
| 0- | 0.5% |
0.9% | 0.7%
| 0.0% | 8.3%
| 0.8% | 0.0%
| 0.5% |
| 10- | 1.7% |
1.9% | 1.3%
| 1.2% | 0.0%
| 0.8% | 0.0%
| 1.7% |
| 20- | 6.9% |
8.1% | 6.8%
| 7.3% | 8.3%
| 11.3% | 0.0%
| 7.2% |
| 30- | 14.6% |
14.1% | 19.4%
| 13.4% | 16.7%
| 21.8% | 20.0%
| 15.05% |
| 40- | 23.5% |
22.3% | 35.4%
| 19.5% | 25.0%
| 21.0% | 30.0%
| 24.1% |
| 50- | 25.8% |
29.1% | 16.1%
| 32.9% | 25.0%
| 25.0% | 30.0%
| 25.6% |
| 60- | 21.6% |
20.1% | 15.3%
| 20.7% | 0.0%
| 14.5% | 20.0%
| 20.8% |
| 70- | 5.5% |
3.5% | 5.0%
| 4.9% | 16.7%
| 4.8% | 0.0%
| 5.2% |
| 80- | 0.0% |
0.0% | 0.0%
| 0.0% | 0.0%
| 0.0% | 0.0%
| 0.0% |
| Total | 6,196
| 1,132 | 602
| 82 | 12
| 124 | 10
| 8,158 |
| % | 75.9% |
13.9% | 7.4%
| 1.0% | 0.3%
| 1.5% | |
|
| Pop % | 92.1%
| 4.0% | 2.0%
| 0.4% | 1.1%
| 0.4% | |
|
|
| Source: UK Transplant, 2007 |
TABLE 3
CORNEA TRANSPLANTS IN THE UK, JANUARY 2005-DECEMBER 2006,
BY ETHNIC ORIGIN
|
| White
| Asian | Black
| Chinese | Mixed
| Other | not rep
| Total |
|
| 2005 | 2,144
| 203 | 66
| 6 | 4
| 16 | 6
| 2,445 |
| 2006 | 2,092
| 280 | 74
| 2 | 2
| 15 | 16
| 2,481 |
| Total | 4,236
| 483 | 140
| 8 | 6
| 31 | 22
| 4,926 |
| % | 86.4 |
9.8 | 2.9
| 0.2 | 0.1
| 0.6 | |
|
| pop % | 92.1
| 4.0 | 2.0
| 0.4 | 1.1
| 0.4 | |
|
| pmp yr | 39.0
| 100.6 | 58.3
| 20.0 | 5.0
| 77.5 | |
|
|
| Source: UK Transplant, 2007 |
TABLE 4
NUMBER REGISTERED ON LIST FOR A LIVER TRANSPLANT IN UK
AS AT 31 DECEMBER 2006, BY AGE DECADE AND ETHNIC ORIGIN
|
| age (ys) | White
| Asian | Black
| Chinese | Mixed
| Other | Total
|
|
| 0- | 17 |
2 | 2
| — | —
| — | 21
|
| 10- | 11 |
— | 1
| — | —
| 1 | 13
|
| 20- | 14 |
2 | —
| — | —
| 2 | 18
|
| 30- | 15 |
— | 2
| — | —
| 3 | 20
|
| 40- | 61 |
9 | 2
| — | —
| 1 | 73
|
| 50- | 103 |
5 | —
| — | —
| 5 | 113
|
| 60- | 63 |
2 | 1
| 1 | —
| 5 | 72
|
| 70- | 3 |
— | —
| — | —
| — | 3
|
| Total | 287 |
20 | 8
| 1 | 0
| 17 | 333
|
| % | 86.2% |
6.0% | 2.4%
| 0.3% | 0.0%
| 5.1% | |
| Pop % | 92.1%
| 4.0% | 2.0%
| 0.4% | 1.1%
| 0.4% | |
|
| Source: UK Transplant, 2007 |
TABLE 5
% REGISTERED ON ORGAN DONOR REGISTER AS AT 31 DECEMBER
2006, BY REGION OF RESIDENCE AND ETHNIC ORIGIN"
|
| Region | White
%
| Asian
% | Black
%
| Chinese
% |
Mixed
% | Other
%
|
|
| Eastern | 97.9
| 0.8 | 0.2
| 0.1 | 0.9
| 0.2 |
| London | 89.8
| 4.8 | 1.9
| 0.4 | 2.5
| 0.6 |
| North West | 98.1
| 0.6 | 0.2
| 0.1 | 0.8
| 0.1 |
| Northern & Yorkshire | 98.4
| 0.6 | 0.1
| 0.1 | 0.7
| 0.1 |
| South East | 97.9
| 0.7 | 0.2
| 0.1 | 0.9
| 0.2 |
| South West | 98.7
| 0.3 | 0.1
| 0.1 | 0.7
| 0.1 |
| Trent | 97.5
| 1.2 | 0.2
| 0.1 | 0.9
| 0.1 |
| West Midlands | 96.3
| 2.0 | 0.4
| 0.1 | 1.0
| 0.1 |
| Wales | 98.8
| 0.3 | 0.1
| 0.1 | 0.6
| 0.1 |
| Scotland | 99.0
| 0.3 | 0.1
| 0.1 | 0.5
| 0.1 |
| Northern Ireland | 99.3
| 0.2 | 0.0
| 0.1 | 0.4
| 0.1 |
| Total | 97.3
| 1.1 | 0.3
| 0.1 | 1.0
| 0.2 |
| Population % | 92.1
| 4.0 | 2.0
| 0.4 | 1.1
| 0.4 |
|
*only where ethnic origin is specified
Source: UK Transplant, 2007
|
TABLE 6
KIDNEY DONORS IN UK, JAN 04-DEC 06, BY DONOR TYPE AND
ETHNIC ORIGIN
|
| Donor type | White
| Asian | Black
| Chinese | Mixed
| Other | Total
|
|
| Deceased | 2,165
| 27 | 16
| 8 | 15
| 3 | 2,234
|
| % | 96.9% |
1.2% | 0.7%
| 0.4% | 0.7%
| 0.1% | |
| Living | 1,486
| 97 | 61
| 6 | 5
| 23 | 1,678
|
| % | 88.6% |
5.8% | 3.6%
| 0.4% | 0.3%
| 1.4% | |
|
| Source: UK Transplant, 2007 |
TABLE 7
TIME ACTIVELY REGISTERED ON LIST FOR KIDNEY TRANSPLANT,
UK*
|
| Ethnic origin | Average wait median (days)
|
|
| White | 722
|
| Asian | 1,496
|
| Black | 1,389
|
| Other | 948
|
|
| *based on registrations in 1998-2000
|
| Source: UK Transplant, 2007 |
TABLE 8
PATIENTS DYING IN 2006 WHILST ON LIST FOR A TRANSPLANT,
UK
|
| Ethnic origin | Kidney
| Pancreas | k/p
| heart | lungs
| h/l | liver
| Total | %
|
|
| White | 212 |
— | 9
| 24 | 50
| 7 | 81
| 383 | 85.5
|
| Asian | 34 |
— | —
| 3 | —
| — | 8
| 45 | 10.0
|
| Black | 10 |
— | —
| 1 | —
| — | 1
| 12 | 2.7
|
| Chinese | 3 |
— | —
| — | —
| — | —
| 3 | 0.7
|
| Mixed | 1 |
— | —
| — | —
| 1 | —
| 2 | 0.4
|
| Other | 1 |
— | —
| 1 | —
| — | 1
| 3 | 0.7
|
| Total | 261 |
— | 9
| 29 | 50
| 8 | 91
| 448 | |
|
| Source: UK Transplant, 2007 |
TABLE 9
WORK ALREADY DONE OR SUPPORTED BY UK TRANSPLANT
|
| 2000— | A multi faith symposium organised by Donor and transplant professionals aimed at the eight major faiths in the UK supported by the Department (Lord Hunt). And senior religious leaders (Bradford 250 delegates from all major faiths
|
|
| 2001— | Arranged a debate for Muftis and Imams in the Muslim school. Unable to go forward with this project due to political reasons
|
| 2002— | Appointment of project worker by UKT, to look at organ donation and ethnicity. Leaflets and booklet produced another seminar (in Birmingham 200 delegates)
|
| 2003— | UKT take over running of all Black and Asian donor campaigns developed by the Department of Health using Black and Asian celebrities to highlight the importance of organ donation and transplantation
|
| 2005— | Developed training for Donor Transplant Co-ordinators and clinicians (Hospital development, Breaking bad news) with a significant component of the training applied to cultural differences
|
| 2006— | Research into attitudes of Ethnic minority groups to organ donation run and commissioned by UKT
|
| 2006— | Developed cultural guide for Health Care Professional as aid for use in interviews when speaking to families with differing and diverse cultural backgrounds
|
|
| Source: UK Transplant, 2007 |
|
|
