{"id":7863,"date":"2020-08-05T12:56:22","date_gmt":"2020-08-05T11:56:22","guid":{"rendered":"https:\/\/www.thinkkidneys.nhs.uk\/kquip\/?page_id=7863"},"modified":"2020-09-04T13:43:15","modified_gmt":"2020-09-04T12:43:15","slug":"birmingham-renal-transplantation","status":"publish","type":"page","link":"https:\/\/www.thinkkidneys.nhs.uk\/kquip\/birmingham-renal-transplantation\/","title":{"rendered":"Renal transplantation"},"content":{"rendered":"\n

Learning from one renal unit\u2019s transformation in response to COVID-19<\/h2>\n\n\n\n
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Authors<\/h2>\n\n\n\n

Miriam Berry, Graham Lipkin, Adnan Sharif, Nick Inston and Steve Mellor<\/em><\/p>\n\n\n\n

Summary of beneficial changes – recovery of transplantation<\/h2>\n\n\n\n
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  1. Individual patient discussions to confirm consent to be re-activated <\/li>
  2. Modified consent process to discus COVID risk with or without renal transplantation<\/li>
  3. Collaborative multi-disciplinary working to support decision making and optimise patient care<\/li>
  4. Pathway for recipient assessment and rapid turnaround COVID-19 testing<\/li><\/ol>\n<\/div><\/div>\n<\/div><\/div>\n\n\n\n

    Summary of beneficial changes – transplant outpatient follow-up care<\/strong><\/h2>\n\n\n\n
    \n
    1. Early implementation of modified immunosuppression protocol for renal transplant patients with suspected or confirmed COVID-19 infection<\/li>
    2. Twice weekly joint surgical\/medical outpatient clinic for essential visits, re-configured and reduced to ensure social distancing<\/li>
    3. Individualised management plan for all transplant patients utilising off-site phlebotomy and telephone\/video clinics to maintain safe follow up while reducing hospital visits<\/li>
    4. Centralised management of patients under satellite clinics to share resources<\/li>
    5. Pharmacy review to ensure judicious supply of immunosuppression<\/li>
    6. Regular use of social media to disseminate updated guidance to transplant population<\/li><\/ol>\n<\/div><\/div>\n\n\n\n

      Acute transplantation activity: Suspension and recovery<\/h3>\n\n\n\n

      University Hospitals Birmingham (UHB)\nprovides renal transplantation services to a catchment area of approximately 5\nmillion people across the Midlands, offering improved quantity and quality of\nlife to patients with kidney disease. We perform more than 180 kidney\ntransplants annually and have one of the longest waiting lists in the UK. <\/p>\n\n\n\n

      The West Midlands, and in\nparticular UHB, experienced very high rates of COVID-19 related hospital\nadmissions with significant impact on Intensive Care services. As a result our\nrenal transplant programme was suspended in late March 2020 due to concerns\nabout the safety of surgery and immunosuppression in an unfamiliar and rapidly\nevolving health crisis. However, our renal patients have been disproportionately\naffected by COVID-19 (in particular those patients receiving in-centre\nhaemodialysis) emphasising the importance of timely and safe resumption of\ntransplant activity.<\/p>\n\n\n\n

      Recovery of transplant activity<\/h4>\n\n\n\n