Wanigasekera, Tamara;
Kim, Isaac;
Maple, Hannah;
Massey, Ashish;
Kiliaris, Maria;
Das, Sharmistha;
Ahmed, Rafez;
... Jones, Gareth; + view all
(2025)
Sharing regional capacity in deceased donor kidney transplantation: experience from a regional collaborative in a metropolitan area.
Clinical Kidney Journal
, 18
(2)
, Article sfae368. 10.1093/ckj/sfae368.
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Abstract
Background. Access to deceased donor kidney transplantation may be restricted in the event of resource limitation induced by extreme peaks in activity or local major incidents, which exceed centre capacity. An organ-sharing protocol was developed by the five London transplant units in 2019 to establish a system for safe transfer of organs and recipients between five regional kidney transplant units. We describe the activity and outcomes over the initial 20-month period. Methods. National data on kidney transplants performed via the collaborative scheme were obtained from National Health Service Blood and Transplant. Outcomes data was collected locally and analysed. Results. Sixteen recipients were transplanted between November 2020 and July 2022. The reasons for referral were theatre capacity and an information technology systems failure. Donor kidneys were from 10 brainstem death donors (62.5%) and six circulatory death donors (37.5%). Half of the donors fulfilled standard criteria. Twelve patients (75%) were first transplant recipients. Three (18.75%) were highly sensitized (calculated reaction frequency ≥85%). Three (18.75%) patients required arterial reconstruction. Seven patients (43.75%) had delayed graft function. Median creatinine at 12 months post-transplantation was 134 μmol/L. The median length of stay was 7.5 days. Three recipients (18.75%) died within the first year, two from SARS-CoV-2 infection. Conclusions. This unique organ sharing collaborative scheme involving five hospitals in London enabled 16 transplants to proceed which otherwise would not have occurred. Although initially established for low-risk donors and recipients, the scheme has evolved to enable transplantation for a wide variety of recipients of varying complexity.
| Type: | Article |
|---|---|
| Title: | Sharing regional capacity in deceased donor kidney transplantation: experience from a regional collaborative in a metropolitan area |
| Location: | England |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1093/ckj/sfae368 |
| Publisher version: | https://doi.org/10.1093/ckj/sfae368 |
| Language: | English |
| Additional information: | © The Author(s) 2024. Published by Oxford University Press on behalf of the ERA. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited. |
| Keywords: | collaboration, deceased donation, equity, kidney transplantation, mutual aid |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Surgery and Interventional Sci UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Surgery and Interventional Sci > Department of Surgical Biotechnology |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10212350 |
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