Transplanting an ethnic community: approaches to the crisis.

only a small percentage of Indo-Asian patients ever Introduction receive a renal transplant. Previously, little data has been available to either Many parts of Europe have in recent years been subject document or explain the extreme imbalance between to large-scale immigration which has dramatically the demand for kidneys by the Indo-Asian population altered the nature if the population. For example, and their supply. However, a number of studies perduring the 1960s and 1970s, the UK experienced largeformed in Birmingham may explain this predicament scale immigration from the countries of the former and suggest possible solutions. The first of these sought, British Empire and has now become home to a number through a retrospective analysis of our patient and of non-indigenous ethnic groups. To obtain employorgan donor databases, to identify the magnitude of ment, most immigrants settled in the industrial areas the demand placed on the transplant service by the of the Midlands and North of England. Birmingham, Asian community and to estimate the level to which in the West Midlands, is the second largest city in the this was likely to rise by the year 2000. It was found country (Greater Birmingham population ~5.5 milthat between 1995 and 1997, Indo-Asian patients lion) and has a prestigious industrial history. accounted for 30% of the patients on the renal transAccordingly, much of the UK’s immigration has been plant waiting list (RTWL), more than double the focused on Birmingham, with the result that ~22% of representation of these individuals in the general poputhe region’s population is now non-Caucasian. The lation. However, during the same period, Indo-Asian largest of Birmingham’s non-indigenous ethnic groups patients accounted for only 13% of the total patients originates from the Indian sub-continent, and this receiving renal transplants. The shortfall existing Indo-Asian community now accounts for 14% of the between the demand for transplantation and the actual region’s population (750 000 individuals). supply of kidneys is therefore considerable.