Living Organ Donation

10 March 2022

Between April 2019 and March 2020 there were over 6,000 patients on the transplant waiting list in need of a kidney or liver. At the end of March 2021, there were 2,959 people in England waiting for a kidney transplant. 1,617 people were on the liver transplant waiting list during 2021.

Liver disease in particular is one of the biggest causes of death in the UK and transplantation is the only cure for liver failure as no device can replace its function long-term. Tragically, while waiting for either organ, 1,118 people died or became ineligible for transplantation during that same period.

That’s why the issue of living organ donation (LOD) was discussed in parliament recently as part of NHS Blood and Transplant’s strategy for increasing living organ donation and transplantation. Sharon Banga, clinical negligence specialist solicitor in Shoosmiths medical negligence team, notes that:

“98% of living organ donation procedures involve kidney transplants with only 2% being liver transplants. These surgeries have differing levels of risk for the donor and recipient and there are some other concerns around whether it is medically ethical to operate on someone who is otherwise completely healthy, exposing them unnecessarily to the risks that any surgery involves. However, the majority of people who agree to LOD do so willingly, with the number of living organ donors in the UK trebling over the last 20 years.”

Before becoming a donor, individuals must first undergo rigorous evaluations to confirm they are suitable for donation, including health and psychological tests, together with motivation and consent assessments. There are four routes for living organ donation:

1. direct donation to a known individual 
2. altruistic donation to a specific individual with no pre-existing relationship
3. altruistic donation to a complete stranger 
4. paired/pooled donation where donor and recipient may be incompatible, so join a sharing scheme in which they are matched with other registered pairs to increase compatibility for the transplants

England introduced an opt-out system in May 2020 following the Organ Donation (Deemed Consent) Act 2019. This means all adults in England are now considered to have agreed to be an organ and tissue donor when they die unless they have recorded a decision not to donate. The deceased’s relatives can override this if they provide evidence that the deceased did not wish to be a donor.

The organ most frequently donated by a living person is a kidney, as was the case with Shoosmiths client Stephen Higham  who suffered kidney failure as a consequence of a delay in diagnosis and treatment and required a living donor kidney transplant from his father.  Thanks to Shoosmiths, Stephen got the compensation he needed and his family the answers they deserved. 

While there are risks for living kidney and liver donors, it is widely accepted that these risks are outweighed by the benefits to the recipient and to wider society. Living donor kidney transplants are the most cost-effective treatment for kidney failure on the NHS, with the potential to save £25,800 per year when compared to dialysis.

Sharon maintains that living organ donation is something people from minority ethnic communities in particular should be especially aware of. Risk factors associated with chronic kidney and liver disease are more common amongst certain minority ethnic groups, which make them more likely to need a transplant. For example, type 2 diabetes, which can lead to chronic kidney disease (CKD) is six times more likely in South Asian communities and three times more likely in African and African-Caribbean communities than in the general population.

The latest available published figures from 2020 suggest that 1,909 people from Black, Asian and minority ethnic communities were actively waiting for an organ transplant and that number is unlikely to have declined much over the past two years. These people accounted for a disproportionately large 32% of the national transplant waiting list, despite minority ethnic communities representing only 13% of the UK population.  Although matching donors and recipients from different backgrounds is possible, for many, the best match will come from a donor of the same ethnic background as they are more likely to have matching blood groups and tissue types.

Sharon comments:

“Having worked on multiple cases involving organ failure and donation, medical experts are clear on the sad fact that there can be a wait of up to three years for a deceased donation, by which time a person’s condition may have worsened beyond the point of being operable or they may have died.  Being privileged enough to have a live donor is a definite advantage, if this can be arranged, as has been shown by some of my clients who have undergone such transplants.” 



This information is for educational purposes only and does not constitute legal advice. It is recommended that specific professional advice is sought before acting on any of the information given. © Shoosmiths LLP 2024

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