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Edinburgh Royal Infirmary Renal Unit EdRen - Edinburgh Royal Infirmary Renal Unit - Renal Transplant... http://www.edren.org/pages/handbooks/transplant-handbook/patie... Home | Unit | History | GPinfo | Handbooks | EdrenINFO | Search | www.edren.org Website of the Edinburgh Renal Unit You are here: Handbooks » Transplant Handbook » Patient Assessment This page was last modified on 03/12/2009 at 10:14. Referral For East of Scotland patients: A referral letter with a transplant recipient check-list and summary (appendix I) should be sent to the Transplant Unit (addressed to Mr J Forsythe; Mr M Akyol; or Mr J Casey, Consultant Transplant Surgeons). All referred patients will be sent an appointment. Lothian, Borders and Fife patients are seen at the transplant assessment clinic in Edinburgh, others are seen in regional units. Patients are seen by a transplant surgeon and recipient transplant co-ordinator. If indicated further assessment by an anaesthetist, psychologist (Appendix III) dentist, dietitian, dermatologist or any other relevant specialist may be sought. Work up for renal transplantation should be carried out at the local centre. Patients will have the opportunity for detailed discussion regarding kidney transplantation and will be counselled with respect to relative risks and benefits of cadaveric and living donor kidney transplantation. An information booklet is also given to the patient to support the verbal information given at the assessment clinic. All patients who are referred for renal transplantation should have risk factors assessed and further screening requested as per Appendix II. Listing Following initial outpatient assessment, those patients who are considered potentially suitable candidates and who remain willing to be considered for a transplant will undergo further investigation as required. The transplant coordinator will arrange for copies of all the required investigations prior to listing. When investigations are complete, the transplant team will review the results. Further investigations and/or treatments may be required at this time. The decision about listing the candidate for kidney transplantation will be made by the transplant surgeons after discussion with the multi-disciplinary team and the patient. A detailed letter regarding the patient assessment will be sent to the referring centre with a copy to the general practitioner. If the patient is to be listed, the patient will be directly informed, verbally and in writing, by the transplant co-ordinator. All patients have the opportunity to be seen for a repeat appointment in clinic before listing. UKT will be informed by the transplant co-ordinator as per unit procedure. Up to top Warning: filemtime() [function.filemtime]: stat failed for /websites/LinuxPackage02/ed/re/n_/edren.co.uk/public_htmlhttp: //www.edren.co.uk/media/download_gallery/EdRenHANDBOOK - Assessment for transplantation.pdf in /websites/LinuxPackage02 /ed/re/n_/edren.co.uk/public_html/modules/download_gallery/view.php on line 428 Warning: filesize() [function.filesize]: stat failed for /websites/LinuxPackage02/ed/re/n_/edren.co.uk/public_htmlhttp: //www.edren.co.uk/media/download_gallery/EdRenHANDBOOK - Assessment for transplantation.pdf in /websites/LinuxPackage02 /ed/re/n_/edren.co.uk/public_html/modules/download_gallery/view.php on line 429 Description Last Change File Size Downloads Archive of Nov 2006 version of Renal Transplant Patient AssessmentJul 23 2009 0 kB 669 Daughter pages of this page (no previous) >> Kidney offer This page last modified 03.12.2009 10:14 by Emma Farrell. www.edren.org is produced by staff of the Renal Unit at the Royal Infirmary of Edinburgh. Please exercise caution in interpreting the information published here, we are fallible and do make mistakes, and written info cannot substitute for expert medical advice. We regret that we cannot give remote advice on the management of individual patients. More about edren, including our confidentiality and privacy policy. Let us know of anything that could be better: contact us. Design modified from an original by Andreas Viklund. This work is licensed under a Creative Commons Attribution-Noncommercial-Share Alike 2.5 UK: Scotland Licence (more info) ARCHIVE VERSION 1 of 1 23/09/2013 14:50 EdRen - Edinburgh Royal Infirmary Renal Unit - Kidney offer http://www.edren.org/pages/handbooks/transplant-handbook/kidn... Home | Unit | History | GPinfo | Handbooks | EdrenINFO | Search | www.edren.org Website of the Edinburgh Renal Unit You are here: Handbooks » Transplant Handbook » Kidney offer Protocols on this page concern Edinburgh management of deceased donor kidneys. Local donation Deceased donor after brain death (DBD) Deceased donor non-heart-beating (NHBD) Local donor procedure Tissue type to be established as soon as possible, usually from peripheral blood lymphocytes (see appendix IV). UKT will inform the donor transplant co-ordinator of the allocation of the kidneys as per National allocation schemes so that the kidneys can be packed and addressed to the appropriate centre. UKT or the donor recipient co-ordinator will then contact the local renal recipient transplant co-ordinator with a kidney or kidney/pancreas offer if appropriate. Offers from Deceased Donors after Brain Death (DBD) (heart beating donors) The on-call renal recipient transplant co-ordinator will receive the offer of a kidney from UKT. Transplant co-ordinator contacts transplant surgeon and asks for a decision as to whether the kidney should be accepted. If the decision has been made to go ahead, then the transplant co-ordinator contacts the patients own local Consultant Nephrologist and the RIE on call Consultant nephrologist, to ensure that the patient is fit and should be called. Donation after cardiac death (non-heart beating donors) NB: Because of difficulties of getting local match run to H&I/coordinators from West of Scotland donors (i.e. those typed in GG&C H&I, Gartnavel Hospital) this revision to allocation will initially be for East of Scotland donors only. Patients for West of Scotland donors will be selected as currently. East of Scotland donors: After receipt of the UKT ‘local’ allocation match run a patient is selected for XM, prioritised as follows: 000 matched patient, or the longest waiting patient in match Levels 2/3 with a current (<3/12) serum sample available who has had no sensitising events since the last sample. If the longest waiting patient is not suitable/available then the next longest waiting patient will be selected, etc Two backup patients will also be selected working down from the top of the match run list who are HLA antibody negative with current (<3/12) sample available. West of Scotland donors: Patients for crossmatch are selected according to the UKT ‘local’ allocation match run. The patient at the top of the run is selected for crossmatch. The reasons for any deviation from this selection must be clearly explained to the coordinator. As the kidney is to remain locally back up patient(s) may be selected for XM in consultation with the local coordinators. Allocation of DCD will be jointly audited by H&I and recipient coordinators and will record how often the above policy was adhered to, reasons for deviations from this policy and the individual making the decision to deviate from the policy. Transplant co-ordinator performs the following tasks: Contact of the patient. Arrangement of transport for the patient and his/her notes to the renal transplant unit. NB: APD patients to bring own machine. Alert renal transplant unit and give details of patient and dialysis needs. Alert the renal registrar with the patient details. Alert Hospital at Night to clerk patient or any other specific requests. Alert the tissue typist with the patient details. It is the responsibility of the transplant co-ordinator to organise theatre. Informing the anaesthetist and on call theatre person to book the first available operating space. It is the responsibility of the renal registrar, and the on call consultant nephrologist to ensure the chosen patient is adequately dialysed and medically fit prior to operation. The on-call renal reg or HAN also liases with BTS regarding grouping and saving. Fife, Dundee, Aberdeen and Inverness patient arrangements: ARCHIVE VERSION 1 of 2 23/09/2013 14:53 EdRen - Edinburgh Royal Infirmary Renal Unit - Kidney offer http://www.edren.org/pages/handbooks/transplant-handbook/kidn... Transplant co-ordinator will discuss the patient with the surgeon and patient’s local nephrologist. If the kidney is to be accepted, the transplant co-ordinator will also inform the RIE consultant nephrologist on-call. The nephrologist or the transplant co-ordinator to contact the patient. The renal recipient transplant co-ordinator arranges transport of the patient to the RIE. The transplant co-ordinator or local nephrologist arranges the patient’s notes to be sent to the transplant unit ASAP. If the patient requires dialysis this is to be organised in Edinburgh. The MRSA and virology status of the patient must be known. Otherwise as above. Up to top Daughter pages of this page Patient Assessment << >> Risk Factors for Graft Dysfunction This page last modified 25.01.2011 10:09 by Emma Farrell. www.edren.org is produced by staff of the Renal Unit at the Royal Infirmary of Edinburgh. Please exercise caution in interpreting the information published here, we are fallible and do make mistakes, and written info cannot substitute for expert medical advice. We regret that we cannot give remote advice on the management of individual patients. More about
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