Many people who choose to donate a kidney do so to help a family member or a close friend (directed donation). However, it’s also possible to give a kidney to a stranger. This is called altruistic (non-directed) donation, and it helps increase the number of kidneys that could be a potential ‘match’ for the more than 6,200 people in the UK waiting for a kidney transplant.
Non-directed donation was made legal in the UK in 2006. In 2024, 5.6% of transplants from living donors were non-directed, but it is a less well-established practice in many parts of the world. This may be because of worries about the ethics of donating an organ to someone you do not know, or concerns from health professionals that non-directed donors are more likely to withdraw from donation or regret donating afterwards.
The Barriers and Outcomes in Unspecified Donation study (BOUnD) is a research project that investigates the experiences of individuals involved in the UK's unspecified kidney donation (UKD) scheme. The study shows that the motivations and outcomes of people who donate to someone they know and those who donate to a stranger are very similar.
Researchers investigated potential living kidney donors from all the UK’s 23 adult kidney transplant centres. Participants in the study completed questionnaires at four points in their donation journey: when they were recruited, two to four weeks before donation, and then three months and twelve months after they donated.
When asked about their reason for donating a kidney, both directed and non-directed donors’ main motivation was the same: to help somebody else. The percentage of potential donors who went through with the donation was very similar between the two groups and the study showed that psychosocial outcomes, such as whether donors felt regret after their donation, were about the same, as was their physical health.
The study should reassure health professionals and potential donors that non-directed kidney donation can deliver all the life-transforming benefits of a donation from a friend or family member.
With the current waiting list for a kidney transplant at its longest in over a decade, non-directed altruistic donation is a vital way to get suitable kidneys to the people living with CKD who need them the most. We are very grateful to the special people who choose to donate in this way to change the future for others.Fiona Loud, Director of Policy, Kidney Care UK
I hope that the results provide reassurance to both potential donors and transplant professionals across the world that, with the appropriate support, these donations can safely proceed and continue to help those in need.Hannah Maple, Principal Investigator for the BOUnD study and Consultant Transplant and Dialysis Access Surgeon at Guy’s Hospital, London