A successful kidney transplant means not requiring dialysis, which is life altering for patients and their whānau. For most people it means a longer and improved quality of life. It gives freedom to travel and freedom in what to eat and drink. It can also mean improved fertility and many people have successful pregnancies after a transplant.
In Aotearoa, around 50 percent of kidney transplants come from deceased donors and the rest are from live donors, usually a friend or family member who is willing to donate one of theirs.
However, approximately 30 percent of potential donors who wish to donate a kidney to a relative or friend are unable to do so due to incompatible blood group or tissue matches. In comes the Australia New Zealand Kidney Exchange programme (ANZKX).
The ANZKX program, run by the Royal Melbourne Hospital, is a collaborative trans-Tasman living donor kidney transplant program involving centres in Australia and Aotearoa. The primary goal of the program is to increase the number of living donor kidney transplants by identifying matches for incompatible donor-recipient pairs, so friends and family who want to donate a kidney to a loved one but aren't a good medical match, can be paired with others in the same situation.
The programme hopes to increase the number of people with kidney failure who are treated by transplantation rather than remaining on dialysis. Transplantation is the best and most cost-effective treatment for kidney failure so the ANZKX programme has the potential to improve outcomes for patients and their whānau while reducing health service costs.
Long-term results from living donor kidney transplants are excellent, with 88 percent of transplants from live donors still functioning five years post-transplant compared with 80 percent for transplants from deceased donors.
A paired kidney exchange can happen when a live donor (Donor #1), who is willing to donate to a spouse, friend or relative (Recipient #1), is unable to donate because they have an incompatible blood or tissue type. ANZKX will help find compatible donors amongst other registered pairs (such as Donor #2 and Recipient #2), enabling two compatible living donor transplants to occur.
Participants in Aotearoa have had both donor and transplant surgery predominantly in Auckland but Wellington and Christchurch will now participate in providing surgeries. As part of building the trans-Tasman collaboration a team of kidney and transplant specialists recently visited the team at Wellington Regional Hospital.
Surgeries don’t always happen in the same hospital and kidneys are often put into chilly bins and flown around the country, and also to and from Australia.
Capital and Coast have been actively involved in the Australia New Zealand Kidney Exchange programme since its conception and have exchanged kidneys with Auckland and Christchurch. Some of these exchanges have been part of trans-Tasman chains.
During 2023, six Wellington regional recipients received a transplant via the kidney exchange, three transplants were performed in Wellington and three in Auckland; four donation procedures were done in Auckland and three in Wellington. 2023 was the programmes most successful year yet with 25 donors in Aotearoa and 55 in Australia.
More and more altruistic donors are also signing up to the programme; these donations set off transplants chains with one in Australia expected to reach 20! Aotearoa has put a lot of energy and focus into increasing the number of living donors, so much so that the number is nearly twice as high as Australia’s.
We are thrilled to be part of this team and part of the exchange and look forward to growing the relationships with our national colleagues and the trans-Tasman team.
Photo caption: The team from the ANZKX programme meeting with our team and senior leadership at Wellington Regional Hospital.
