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Kidney donation: the chance of finding a match
00:28:11
The chance of a successful kidney match between two unrelated people has increased in...
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- [00:00]
Tim Harford
Thank you for downloading More or Less from the BBC. This is the version of the programme first broadcast on BBC Radio 4. Here's Tim Harford.
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Hello and welcome to More or Less the programme which dances daringly with the data that surround us in the news and in life. In this week's programme we look at who gets more of our money, animal charities or human ones. We consider whether Britain is poorer than almost all American states. And we celebrate coincidence.
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Michael Blastland
The chance that there's going to be something in common somewhere between two people is pretty good and very often remarkable. Eyebrow raising, hair raising.
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Tim Harford
But first, as you may know, More or Less always encourages loyal listeners to email in with their statistical queries. There are some requests and ideas we ignore. They're the ones from our editor, Richard Varden. The man has a mind like a sewer, honestly. But recently we, we received one email from Avadan. We were about to mark it as spam and then we realised it wasn't from our editor, but from his mum, Kay Varden.
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Ruth Alexander
Ruth.
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Tim Harford
She's a lovely woman, isn't she?
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She is lovely and we definitely listen to the editor's mum, if not the editor.
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We do indeed. She's a particularly loyal listener who, it turns out, had an interesting question.
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Kay Varden
My husband had problems with his kidneys and they gradually got worse and in the end they put him onto the pre dialysis clinic and said he had end stage kidney failure and if he didn't have a transplant he would need to go on dialysis. They talked about all the different options about kidney transplants and I hadn't realized that there was any chance that you could do a live transplant if you weren't actually a blood relative. But they said oh yes, they would do tests and see if I might be a match. And so then I had various tests and we were rather surprised and very pleased to find that I was a suitable match.
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Producer/Presenter (possibly Tim Harford or a co-host)
Well, being a numbers programme then, what can we do for you?
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Kay Varden
I want more or less to find out what are the chances of two people like myself and my husband being compatible?
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Producer/Presenter (possibly Tim Harford or a co-host)
We will find out for you and we promise to report back.
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Tim Harford
So should Kay be surprised?
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Kidney transplant surgeons are busy people, but we managed to get an early morning interview over an Internet line with Professor Anthony Warrens, president of the British Transplantation Society.
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Professor Anthony Warrens
Well, she shouldn't be surprised because we're now doing very large numbers of living donation exactly like this spouse to the partner. And the outcome really is fantastic now. And that's because we've learnt to do some manipulation of the immune system. That makes it possible to do transplants that frankly wouldn't work 15 years ago. Technology and the clinical practice has improved really very significantly.
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Tim Harford
There are two big things kidney transplant surgeons think about.
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Professor Anthony Warrens
Number one is blood group compatibility. And that used to be an absolute barrier. If people were incompatible, they just were untransplantable. We now are able to remove the antibodies that we have in our blood to cause the damage to somebody whose kidney is blood grouping compatible? And the outcome having removed those antibodies is pretty close to the same as if there was no blood group incompatibility. I should say it doesn't work for everybody, but it works for 75, 80% of people who are blood grouping incompatible if we're able to remove the antibodies. The other thing is what we tend to refer to as tissue typing, and this revolves around a system of molecules called hla. The details don't matter. This is a higher hurdle. But we've now learned with the immune suppressive drugs we've got available, that we can actually in most cases suppress a lot of the immune response. And so the outcome is again close to, not the same as, but close to comparable for people who have got very well tissue type matched kidneys.
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Tim Harford
Well, three cheers for improvements in technology and clinical practice.
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Rather than asking ourselves what are the chances of a match, then the pertinent question to ask now is how successful is a transplant likely to be?
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Professor Anthony Warrens
The chances of a kidney still working at one year is 95%. And if we look at, let's say, 10 years down the line, in general terms, I would say a very well matched kidney has got a 75% chance of working, and a badly matched kidney maybe has a 65% chance of still working at 10 years. These are very general figures, but it gives you some sort of idea of the impact of matching.
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Tim Harford
So far we've been considering donations from living people such as Kay, but many organs are actually harvested from people after their death. And it's this process that gives us the number you may remember most from this week's program.
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Professor Anthony Warrens
If you consider transplantation of all organs, a person who has agreed to donate his organs after his death will generate on average an extra 56 years of added life in other individuals. That's a major contribution.
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Tim Harford
And in case you're thinking that sounds just like the sort of statistic we should check, well, we did. Here's an extract from a paper published in the American Journal of Transplantation.
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Hannah Moore
An average Organ donor provides 30.8 additional life years distributed over an average 2.9 different organ transplant recipients, whereas utilisation of all organs from a Single donor provides 55.8 additional life years, spread over six organ transplant recipients.
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Tim Harford
Published almost 10 years ago. So maybe it's even more now.
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And so, Kay, to give you the final answer, the chance of two unrelated people being a perfect match is one in a hundred thousand. But with medical and technological developments, you don't need to be a perfect match anymore for a kidney transplant to work. So the chance of you and your husband being a good match were, in the words of Professor Warrens, remarkably high. Best of luck to you both.
- [06:14]
Thank you to Professor Anthony Warrens, President of the British Transplantation Society, and thank you, Ruth. You're listening to More or Less, and I'm Tim Harford. Our email address is more or lessbc.co.uk. time for a quick rant. An article published on the BBC website
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Hannah Moore
this week announced six regions hit new house price peak, says Office for National Statistics.
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Tim Harford
The article went on to report that
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Hannah Moore
East Midlands, West Midlands and South west of England have joined London, the east of England and the south east of England in rising above the peak of late 2007 and early 2008.
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Tim Harford
Fair enough, but are those numbers adjusted for inflation or not? When the BBC reports economic growth, for example, it adjusts for inflation. 4% nominal growth with 1% inflation is reported as 3% growth, not 4. But the House price figures aren't adjusted for inflation and this wasn't something the BBC article mentioned. I don't want to split hairs here because either way of reporting the figures is useful, but it would be nice to be told which one is being used. Last week there was some very sad news.
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Hannah Moore
60 dogs are killed in a fire at a Manchester dogs home. A 15 year old boy is arrested
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Tim Harford
on suspicion of arson. But then there was some happier news. A fund to help a dog's home in Manchester, which has been partly destroyed by fire, has raised more than a million pounds. The generosity of the great British public quickly flowered. Meanwhile, on BBC Radio 4's Today programme, while interviewing the three men who bravely entered the dog's home to rescue some of the animals, the presenter Justin Webb expressed his surprise that the public had donated so much money.
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Ruth Alexander
Isn't it slightly odd because we raise money so quickly, so easily for these dogs? There are so many people in desperate desp genuine need. We find it so much more difficult to raise money for them. It's odd, isn't it?
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Tim Harford
This prompted loyal listener Barbara to write to more or lessbc.co.uk to ask I've
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Hannah Moore
heard this comment trotted out before that we are more generous towards animals than
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Tim Harford
people, but I don't think it's true.
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Hannah Moore
I would be interested to hear the facts and evidence surrounding this, if you could, please.
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Tim Harford
Well, Barbara, I put our dog correspondent Ben Carter on the case. Ben, Hello.
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Ben Carter
Hi, Tim.
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Tim Harford
You've been looking at the numbers. What do they tell us?
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Ben Carter
Well, people who donate to charity give 5% of their money. Animal charities.
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Tim Harford
And how do you know that?
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Ben Carter
Well, this statistic comes from the Charities Aid foundation and the National Council for Voluntary Organisations. Now, they work with the Office for National Statistics to produce an annual overview of charitable giving in the UK.
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Tim Harford
Fair enough. A good source, presumably. The other 95%, then, are donations to human charities, broadly conceived. I'm assuming there aren't any charities for pet rocks.
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Ben Carter
Well, no, not pet rocks, but there are environmental charities, of course.
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Tim Harford
Fair enough. Okay.
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Professor Anthony Warrens
Yeah.
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Tim Harford
We can save the planet, we can save the oceans, we can save the trees.
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Producer/Presenter (possibly Tim Harford or a co-host)
That's right.
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Tim Harford
We can take a broad view of this. Okay. But human charities still get a lot of money.
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Ben Carter
They do. But people give the most to medical research charities. They receive 16% of all donations. There are a few categories of charity which each attract about 10% of total donations. Those which collect money for hospitals, children, overseas aid and religion.
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Tim Harford
So they all attract more money than animal charities. What types of charity get less?
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Ben Carter
Charities for the elderly, disabled and homeless. They all get less than 5% of total donations, which puts them behind animal charities.
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Tim Harford
So knowing what we now know about the level of giving to animal charities, it's pretty solid. It's middle of the table stuff. So I presume the money that's been raised for Manchester Dogs Home, it's pretty unusual.
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Ben Carter
We'll put it this way. Over the past year, £5 million was given to the top 100 animal charities through the Justgiving website. Manchester dog's home received £1 million in a single day.
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Tim Harford
Gosh, I suppose sometimes these things just catch the public mood. As with the Ice Bucket Challenge we discussed a couple of weeks ago.
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Ben Carter
That's right. Or the late Stephen Sutton's fundraising campaign for the Teenage Cancer Trust. He raised five million pounds in just a few months.
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Tim Harford
So these are remarkable stories and they grab attention. But, Ben, the statistics tell us we do give more money to people than to animals.
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Ben Carter
They do.
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Tim Harford
Well, thank you, Ben. And thank you, Barbara, for your question. You're listening to More Or Less, and I'm Tim Harford. The journalist Fraser Nelson caused quite a stir recently when he wrote an article for the Daily Telegraph. In which he said that if Britain were to leave the European Union and become the 51st state of America, we would actually, if you take our economic output, adjusting for living costs, be the second poorest state in the Union. Only Mississippi would be poorer. This comment was met with both skepticism and annoyance by many proud Brits online. But was Fraser Nelson right? Chris Dillo, who writes for the Investors Chronicle and who has a blog called Stumbling and Mumbling, has been checking the numbers. I started asking him why so many people question Fraser Nelson's assertion.
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Ruth Alexander
He mentioned the southern states to the typical Englishman. He pictures deliverance and men playing banjos and he's got all these images of quite a poor country. But in fact, that's a very outdated image. And the southern states have grown very strongly over the last 40, 50 years.
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Producer/Presenter (possibly Tim Harford or a co-host)
Talk us through how you subjected Fraser's number to an independent assessment.
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Ruth Alexander
UK GDP last year was 1.6 trillion pounds. Now, if you divide that between 64 million of us, you've got GDP per head of just over 25,000 pounds. Now, the exchange rate last year was 1.57. So that gives us GDP per head in dollars of just over 39,000. In the US, you've got GDP per head of just over $53,000. So it looks as if the United States are $14,000 per person richer than us. What I decided to do then was to forget that calculation and look at wages. We know from the UK that the median full time male worker gets 556 pounds per week. Now, the typical American worker, this is a man, gets $860 per week. Now, if you convert that at an exchange rate of about 157, they're very close. There's something else, which is that a lot of prices in America are a lot, lot lower than in the uk. And this means that in terms of what your money buys, you're much better off in America. So what I thought I'd do was I'd have a look at the prices of actual goods in the shops. Take a dozen eggs. These cost just over £3 in the UK, but they cost only $1.95 in
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Producer/Presenter (possibly Tim Harford or a co-host)
the US, which is about £20, something like that. So as much less than half the price? Yeah, I mean, I guess we all know about petrol. Petrol's a lot cheaper in the United States.
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Ruth Alexander
Petrol's a lot cheaper, but so are most of the staple foodstuffs. I mean, milk, mints, coffee. I looked at several things and the picture is pretty similar.
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Producer/Presenter (possibly Tim Harford or a co-host)
None of this is super statistically rigorous. It's just a sort of a basic reality check that you're able to do armed only with Google that says, really, it shouldn't be surprising to find out that the UK does, does not stack up terribly well in GDP terms relative to most American states.
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Ruth Alexander
Yeah, exactly. Well, we can come at this in two different ways. GDP per head tells us that the Americans are doing better than us, but so too do wages and individual prices.
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Producer/Presenter (possibly Tim Harford or a co-host)
What's the counter argument? That actually the UK is not doing as badly as those economic statistics seem to suggest. And in many ways life in the UK is better than those statistics suggest.
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Ruth Alexander
There's quite a few things that these figures miss. One is that Americans work more hours than we do. We've got some OECD figures which show that Americans put in 7% more hours per year. So they're richer than us, in part simply because they work harder. There's also the question of health care. Americans spend 7.6% more of their GDP on healthcare than we do in the UK. So once you take account of those two facts, the gap between the British and the Americans narrows quite dramatically.
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Producer/Presenter (possibly Tim Harford or a co-host)
So you're not saying we should all immediately emigrate, but you are saying, on the face of it, Fraser Nelson's claim, which seemed surprising, surprised you. It's perfectly plausible.
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Ruth Alexander
It is plausible. But there is one other big point here, and that is that GDP and incomes aren't necessarily a guide to the quality of life. And there may be factors in the quality of life that mean it's better to be English than American.
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Tim Harford
Chris Dillo, who blogs at Stumbling and Mumbling, showing us that these days, if you want to check what seems like a dodgy statistic, an Internet connection and the back of an envelope are often all you need. One group of animals has truly colonized the Earth. They number more than 100 trillion the ant. And you know, for every human on our planet, there were more than 14,000 of these. And if we were to weigh all of the ants in the world, they would weigh as much as all of the people.
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Producer/Presenter (possibly Tim Harford or a co-host)
Hmm.
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Tim Harford
BBC4's the Wonder of Animals, the Ants edition, in case you were wondering. And loyal listener Adam Richardson thought this sounded a bit dodgy. He's not the only one. So he emailed more or lessbc.co.uk and he challenged us to find out the truth. So how heavy is an ant? Has anyone ever weighed them? How do you weigh an ant? Hannah Moore's been crawling about with her magnifying glass and her super sensitive set of scales, and she can tell us
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Hannah Moore
now A bit of history first, Tim. This claim was Originally made by Dr. Edward O Wilson, a professor at Harvard University, in his 1994 book, Journey to the Ants.
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Tim Harford
I know his work. He's a top biologist, a leading antspirt.
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Hannah Moore
All the same, Adam insists we fact check. So I emailed Edward Wilson to ask how he calculated it and he here's the basis.
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Ben Carter
An estimate made by an earlier ecologist that there are 10 to the power
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Tim Harford
of 18 insects of all kinds.
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Ben Carter
I'll add the guess that 100th of them, hence 10,000 trillion, are ants. Each human weighs roughly 1 million times as much as each ant on average, and there are 7.2 billion humans alive, hence maybe all the people and all
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Tim Harford
the ants weigh the same.
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Hannah Moore
In case you're confused, Professor Wilson is rounding here. So 7.2 billion humans becomes roughly 10 billion humans for the purposes of this estimate.
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Tim Harford
But E.O. wilson says there are 10,000 trillion ants in the world. But on the BBC4 documentary it was claimed there are just 100 trillion.
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Hannah Moore
That's the first problem. I've spoken to lots of antsperts this week from Bristol University's Ant Lab, the Bees, Wasps and Ants Recording Society, the Natural History Museum.
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Tim Harford
There's no stone unturned.
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Hannah Moore
Well, that's the problem. There are too many stones to turn over. No one knows how many ants there are in the world.
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Tim Harford
I suppose they are very small and quite fast and they're generally rather discreet little fellows altogether, so it makes things tricky. But let's see what we can do. According to Dr. Wilson, humans weigh on average a million times more than an ant. So what does the average human weigh?
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Hannah Moore
62 kilograms. Let's call it 60 kilograms. Divide that by a million and you get 60 milligrams.
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Tim Harford
So about a fifteenth of a gram, Is that about right? I realise I have absolutely no idea how much an ant weighs.
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Hannah Moore
Well, I've been looking into this and I found out that ants are vary greatly in weight, which again makes Dr. Wilson's calculation problematic.
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Tim Harford
So how much do they vary by?
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Hannah Moore
There are about 13,000 species worldwide ranging from less than 1 millimetre to 30 millimeters in length.
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Tim Harford
30 millimeters? That's as long as a decent sized thumb. Monster ants.
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Hannah Moore
They're actually called dinosaur ants, Tim.
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Tim Harford
Anyway, that's so cool. Sorry, go on.
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Hannah Moore
Anyway, experts agree the average ant weighs about 6 milligrams, making it roughly 15050 ants to the gram.
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Tim Harford
So that's a tenth the weight of Dr. Wilson's estimate. But hang on, how do you even weigh an ant? Well, I spoke to Francis Ratniex. He's professor of apiculture at the University of Sussex. And as you probably guessed, apiculture is something to do with ants and also bees.
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Francis Ratniek
It's very easy to weigh an ant. You buy a small electronic balance, a few hundred pounds, maybe a thousand for a really fancy one, and you pop the ant on the balance. One way you can easily do it is by cooling the anti, and that way it stops moving and you can put it on the balance and it doesn't run away.
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Tim Harford
So Dr. Ratniek's advises, this is a pro tip. You chill your ant well before weighing it. Now, did he think there was any truth to the statement that all the ants in the world weigh as much as all the humans?
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Francis Ratniek
I don't think it's true now, but if we go back in time, I'm sure it was true at one point. If we go back several thousand years, I'm sure that the humans, who were much less numerous and also less fat than they are today, would have weighed less than the ants. So maybe two or 300 years ago, that was the point at which humans outweighed the ants.
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Tim Harford
Frances Ratniex, professor of apiculture at the University of Sussex, and Hannah Moore. Thank you, Hannah.
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Hannah Moore
Thanks, Tim.
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Tim Harford
You're listening to More or less now. Friday, September 19, the day this program is first broadcast, is Hunt Rods Day. What is Hunt Rods Day? I hear you ask. Good question. It's the brainchild of David Spiegelhalter, Timandra Harkness and Michael Blasland, communicators of scientific ideas and friends of numbers everywhere. The aim of Hunt Rods Day is to celebrate the extraordinary coincidences that occur in our lives. But who or what are Hunt Rods? We invited one of the founding members of More or Less, the aforementioned Michael
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Michael Blastland
Blasland, to explain Frances and Mary huntrods. Born on September 19, 1600. Both of them. They married each other on September 19. They died on September 19, both of them, within five hours. So born, married, died all on the same day of the year and not
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Producer/Presenter (possibly Tim Harford or a co-host)
in some horrible accident?
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Michael Blastland
Well, we don't know. I mean, was this like the last act of Hamlet where everybody slaughtered each other? We don't really know the circumstances in which this happened, but it's a wonderful story. They were. They lived for 80 years. They were married. We don't know for quite how long, but together for a very long time. They had 12 children. All this is commemorated on a stone in Whitby churchyard, which, coincidentally, is the church that inspired Frankenstein.
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Producer/Presenter (possibly Tim Harford or a co-host)
Now, this was observed by your friend and my friend, Professor David Spiegelhalter, Sir
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Michael Blastland
David Spiegelhalter, well known around these parts.
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Producer/Presenter (possibly Tim Harford or a co-host)
And you and David want to celebrate Huntrod's Day.
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Tim Harford
We want to use this.
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Producer/Presenter (possibly Tim Harford or a co-host)
Apart from just having an excuse to have a holiday, what's the story?
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Michael Blastland
We want to use this as a way of talking about chance and coincidence, really. The upside, especially of chance and probability. We spend a lot of time talking about whether or not we're all going to be struck by lightning or killed by Ebola or whatever it is. And coincidence is just a wonderful reflection of the vast, vast number of possibilities that exist in the world, if only we all go out and explore them, if only we have those kind of conversations on the tube with the person sitting next to us. The chance that there's going to be something in common somewhere between two people is pretty good, you know, and very often remarkable. Eyebrow raising, hair raising, you think, how could that possibly happen? Two people born in the same bed becoming married, for example. We're pretty sure that there are going to be thousands of people out there who share a birthday with their spouse or their partner, for example. Just the odds are such as that. But it doesn't strip all the magic out of it. This is the lovely thing about coincidences, because you never quite know who. There have been a few stories recently. There was Mr. And Mrs. Pulsford of Pagam and they celebrated their 80th birthday on the 8th of August 8th of the 8th, 2008. Nice little coincidental symmetry. There was another couple in the newspapers recently that got married. They were flicking through his pictures, I think it was, of his childhood on the beach. And there she was, a few meters away, playing on the same beach. They were in the same, unknown to each other at that time. So the possibility that these things are out there in infinite numbers is just too delicious to resist.
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Tim Harford
I think the great Michael Blastland, one of the creators of More or Less, and how could we resist? Do please send us your wonderful tales of coincidence and we'll share the most eyebrow and hair raising in our final programme of the series next week. Late last year, BBC trending reported the tale of a musician from Eritrea. He was causing a stir on YouTube with a protest song that appeared to criticise the government. The coverage of the story resulted in several complaints being sent to the BBC's Editor Editorial complaints unit. Most were not upheld. Most. I brought BBC trending producer Mukul Devachand into the More or Less studio to confess his mistake.
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Mukul Devachand
We did say one thing, which was wrong.
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Producer/Presenter (possibly Tim Harford or a co-host)
And that was.
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Mukul Devachand
We called Eritrea.
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Producer/Presenter (possibly Tim Harford or a co-host)
Tiny, tiny Eritrea.
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Mukul Devachand
That's right, tiny Eritrea.
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Producer/Presenter (possibly Tim Harford or a co-host)
And the BBC upheld complaints because you weren't supposed to refer to Eritrea as tiny.
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Mukul Devachand
Yes. I now know that the CIA World Factbook have Eritrea ranked as the 101st biggest out of 252 countries in terms of size.
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Producer/Presenter (possibly Tim Harford or a co-host)
And measuring it in terms of square kilometers, that is 117,600. So that's bigger than 60% of all other countries. It's not really tiny at all. It's in the top half of all the countries in the world measured by area.
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Mukul Devachand
Eritrea. I now know I've not been there. ETREA is definitely not tiny. And I have to say, as somebody from Wales, the country that often gets referred to as the standard shorthand for small countries, I feel particularly bad for having let that get through. Eritrea, it turns out, is six times the size of my homeland Wales.
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Producer/Presenter (possibly Tim Harford or a co-host)
Wales, just over 20,000 square kilometers just above Israel in terms of size and just below El Salvador. So Mukul, is Wales.
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Tim Harford
Tiny, tiny whales. You come here from tiny Wales.
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Mukul Devachand
For obvious reasons, I now will never ever refer to any country by itself size alone.
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Tim Harford
Wise man Mukul Devachand from BBC Trending. Eritrea clearly isn't tiny by area. It's larger than over half the world's countries, including South Korea, Hungary and Ireland. It's more populous than Libya, Singapore, Norway or again Ireland. But it got me thinking that there must be somewhere we could describe as tiny. The Pitcairn Islands have a population of 56. The Vatican City. A country is entirely surrounded by Rome. I walked all the way around it one afternoon with my 8 year old daughter. These places really are tiny, although it might still be rude to say so. So what's the cutoff? Well, I've been having a think. Perhaps tiny countries could be said to be those which have a population of fewer than 1 million and a land area of 10,000 square kilometers or less. That's about 60 miles by 60 miles. By the way. These are nice round numbers. And most countries are larger by at least one of these measures. If we did adopt this twin test as the official BBC definition of tininess, the largest tiny country in the world would be Cyprus. But we didn't just want to assume it would be okay to talk about tiny Cyprus. No, no, no. So we called the press office of Cyprus UK Embassy to find out how they'd feel. And so it went on. Not a man to be easily defeated. I called back and went straight to the operator.
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Producer/Presenter (possibly Tim Harford or a co-host)
Good morning, this is Tim Harford calling from the BBC.
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Tim Harford
Is the press office open at the moment? Please try.
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Francis Ratniek
For you, one moment.
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Tim Harford
Thank you. On and on the phone rang. It then became clear to me that Cyprus is so tiny it doesn't have enough people to man the press office phones. We'd like to apologise in advance for this feature to Cyprus and to the BBC's editorial complaints unit. Send your complaints or your comments, your questions and your coincidences to more or lessbc.co.uk and if you'd like a free download of this program, you are very welcome to it. Just go to BBC.co.uk more or less. Thank you for your company and until next week, goodbye.
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More or Less was presented by Tim Harford, the Financial Times undercover Economist. It was produced by Ruth Alexander and made in association with the Open University. You can Download many more Radio 4 programmes for free. Find these@BBC.co.uk Radio 4.