The Transplant team is led by Mr Keith Graetz (Clinical Director, Transplantation). The service provides acute and chronic transplantation services for the region, including all work up, surgical, nephrological and nursing care, dedicated anaesthetic staff, transplant coordinators (living donor, recipient and post-transplant), surgery and immediate, middle- and longer-term post-transplant management for donors and recipients. Hand-assisted laparoscopic nephrectomy is the donor operation of choice although it is likely that we will offer robot assisted surgery to selected patients in the future. There are a good number of local DCD (Donation after Cardiac Death) donations and a dynamic and increasing living donor programme, with one of the highest number of non-directed altruistic donations in the country. The local commissioners favour transplantation, particularly pre-emptive (where patient has not started dialysis yet). Four Nephrologists provide the immediate peri- and post-transplant care with the transplant surgeons and specialist nursing team.
Alongside transplant surgery services we have involvement in emergency and elective general surgery, paediatric surgery and non renal vascular access. This allows us to provide a full surgical service to the majority of patients who come through the renal unit.
Six transplant surgeons also provide a dedicated vascular access service, with good links to vascular imaging and interventional radiology, and excellent primary and secondary patency rates. This is evidenced by more than 80% of the service’s patients dialysing via a native fistula or graft, with the expectation of exceeding 85%. Two vascular access specialist nurses provides and coordinates fistula and graft monitoring with pre-emptive investigation and treatment, further maintaining good access quality.
The Unit takes on around 110 new patients with end stage renal failure per million adult population per year, and undertakes approximately 100 renal transplants per year, including ABO-incompatible transplants. It refers patients for pancreas-kidney transplantation to the Oxford Transplant Centre, which performs monthly assessment clinics within the outpatient department on the Renal Unit. The unit has around 1000 patients with functioning transplants.
The Unit employs Living Donor Transplant Coordinators, Recipient Transplant Coordinators, Renal Dietitians, Renal Pharmacists, an excellent admin team and a Transplant Immunosuppression Service team. There are excellent committed nurse specialists in vascular access, transplantation, pre-dialysis care, home haemodialysis, peritoneal dialysis and anaemia management, who actively participate in and lead multidisciplinary team meetings, nurse-led and -supported clinics, audit and research.