Increased intensive care unit (ICU) capacity is among the requirements necessary to grow the living kidney transplant programme, according to the National Kidney Transplant Service (NKTS) Annual Report 2024.
Transplant recipients need to be monitored in ICU in the early post-operative period. A spokesperson for Beaumont Hospital in Dublin, where the NKTS is based, said a new consultant nephrologist/general physician post had been approved under the expansion of the living donor programme. However, Beaumont was “not aware” of any further national resourcing for this area, “including for ICU capacity to facilitate more living donations.”
According to the NKTS annual report, awareness of living donation is “perhaps our greatest resource” in terms of increasing the number of kidney transplants.
In 2024, the NKTS performed 30 living donor transplants. There were also nine ‘paired kidney exchange’ living donor transplants through a collaboration with the United Kingdom Living Kidney Sharing Scheme.
The NKTS report noted that living donor kidney transplant had “many advantages” over deceased donation, including reduced waiting time and increased graft survival.
In Ireland, living kidney donors are family members or friends known to the recipient. New legal provisions will expand the potential donor pool to also include non-directed altruistic living kidney donation (ie, donation to the transplant system rather than to a specific person). The provisions, commencing on 17 June, are part of wider legislative reforms.
According to the Department of Health, in 2025, an additional €2 million has been made available through HSE Organ Donation and Transplant Ireland (ODTI) for “increased staffing”, expansion of the national potential donor audit, and the development of the national organ retrieval service.
Meanwhile, Beaumont confirmed it has not received HSE funding for vital equipment required by the National Histocompatibility and Immunogenetics Service for Solid Organ Transplantation (NHISSOT).
A NHISSOT business case, submitted in 2024, included a requirement for a new molecular HLA typing and antibody screening system. The current system was almost 10 years old and the service provider had “announced the end-of-life of the instrument”.
“If we have downtime and parts are not available we will no longer be able to provide a routine HLA typing service nationally,” stated the document obtained from the HSE under Freedom of Information law.
The business case noted that patients cannot be activated on the solid organ transplant pools without complete HLA typing. Patients requiring urgent transplant could be activated on the waiting lists with limited HLA type (by serology), but the service would be unable to report full match grades to transplant surgeons.
A HSE spokesperson said: “The requirements to develop the service will be scoped and prioritised for the HSE national service planning process for 2026. This will build on previous investment in National Service Plan 2022, which led to the new appointment of two senior scientists for NHISSOT.”
In regard to living kidney donation, ODTI will be working with the NKTS over the “upcoming months” to prepare for the 2026 HSE service planning process.
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