South Asian patients awaiting organ transplantation in the UK

Background. The fate of ethnic minority patients with end-stage renal failure is often a concern due to differences in disease profile, blood groups and difficulties in organ matching. This is an issue for Asian patients in particular, and there are more Asians on the UK transplant waiting list than expected. Methods. We reviewed the available evidence along with recent data from UK Transplant in an attempt to summarize the current situation and to suggest improvements. Results. While Asians comprised 13.6% of the UK waiting list, only 0.9% of non-heart-beating donors and 1.8% of heart-beating donors were Asian. Refusal rates from relatives for deceased donation were 78.7% for Asians and 31.8% for Caucasians, but approach rates were 89.4% and 95.1%, respectively. However, 7.3% of living donors were Asian. Conclusions. Changes to the UK National Kidney Allocation Scheme in 2006 may improve access to organs for Asian patients. The interaction of biological, cultural and organizational factors affecting Asian patients needs to be considered carefully to ensure that these patients are not disadvantaged.