Studies of kidney transplantation at the front line have touched on a realistic view. Following the first successful kidney transplant in 1954, the clinicians involved discussed the relevant biology surrounding transplantation, those of immune system rejection where a recipient’s body would attack the foreign organ, and this understanding of “why” informed the “how” of performing the procedure and managing the transplanted patient after the procedure.

Transplantation has grown to be a relatively routine practice, happening on an international scale. With a limited number of organs available, prioritisation schemes have been developed in many countries in order to get organs to the most appropriate patients.

With this growth, we see a shift towards a positivistic approach. Measurable and objective factors are recorded and used in the decision making process from the retrieval of organs, where organs are taken from both deceased and living donors; the allocation of organs, where policies are created and evolved to offer certain organs to certain patients; and then acceptance of organs, where clinicians play a large role in deciding to accept or reject an organ for their patient.

Within all of this, correlations and statistical analysis influence the “how” and it is not often that we stop and take a step back to see the forest for the trees and look at “why”.

Knowledge is generated much how many of us expect medicine to go about this. Nurses, doctors and technicians perform tests on a variety of objective and measurable factors to do with donors, patients and even the logistics involved between getting an organ from one to the other.

All of these measurements are collected and collated and are used to paint a picture out of numbers that tell us about a patient, an organ or a donor.

These combine with outcomes, again objective and measurable, and are fed in to statistical model building to inform us about what factors are important in a successful transplant.

Where we lose information is in the human factors at play, which are much less tangible to measure. Families who have just lost a loved one may only want to donate to certain people or certain organs; patients may only be comfortable receiving organs from certain donors; and a big place that this human element can be lost is in living donation, where there are common stories of the the psychological benefits to the donor being overwhelmingly positive; a message that is easy to lose in the numbers.

For my presentation, I will be considering these human factors and the part they might play if knowledge were generated beyond measurements, box ticking and spreadsheets.