Dr. David Hickey:

It is an important question. We had a sharing arrangement with the United Kingdom between 1989 and 2001. Everything Dr. Plant described came to fruition. There was a negative balance of trade every year and, because of transportation, even for the best matched imported kidneys, we had no knowledge about who had removed them, how they had been managed in ICU or the quality of the ICU concerned.

We had no control over that. The best-matched imported kidneys did worse than the worst-matched local kidneys and we pulled out of that arrangement. Generally speaking, again, with 60 millionin the UK, the smaller centres do not get the rewards. They become demoralised, their efforts deteriorate and organ procurement declines as a result. That has been the situation in the US where big centres have cannibalised small centres, and everybody is a loser when that happens. We must maintain our own integrity here. There are situations where a bigger pool like the UK is important, such as the paired organ exchange which Professor Conlon is running. We are involved with the North for pancreas transplantation. There are 27 co-ordinators there. Maybe they could spare some for us. Involvement with the North may be a possibility. Professor Conlon would know better than I do. I do not know. In terms of the deceased donation rates here, we should look after our own people first and export what we cannot use.