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Renal Transplant Audit April 2010-April 2011

Department of Renal Surgery Queen Elizabeth Hospital Birmingham. Renal Transplant Audit April 2010-April 2011. Mr ER Faulconer ST4 General Surgery. Sources. Prospective departmental database (HK) PICS NSRI database (KT and AO) Previous audits (SM, NI, DvD). Content.

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Renal Transplant Audit April 2010-April 2011

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  1. Department of Renal Surgery Queen Elizabeth Hospital Birmingham Renal Transplant Audit April 2010-April 2011 Mr ER Faulconer ST4 General Surgery

  2. Sources • Prospective departmental database (HK) • PICS • NSRI database (KT and AO) • Previous audits (SM, NI, DvD)

  3. Content • Present Data for last financial year • Compare to previous year’s data • Note trends over last 3-5 years • Audit points • Change in workload • Differences in BMI outcomes • Deaths and Graft Losses

  4. Activity

  5. Referring Units

  6. Demographics

  7. Demographics (2)

  8. Cause of Renal Failure

  9. Donor Details

  10. Matching

  11. Cold Ischaemic Time

  12. Baseline Immunosuppression

  13. Delayed Graft Function

  14. Outcomes • Creatinine at 3 months (median) umol/L • All patients – 115 • LD - 102 HBCD – 126 NHBCDT - 196 • Graft loss • <1 yr = 14 <1 month = 5 • Death • <1 yr = 4 <1 month = 1

  15. Complications • Rejection • 2009-102010-11 • 22 (14.9%) 12 (10%)

  16. Complications

  17. Outcomes by BMI

  18. Graft Losses • n = 14 • 9 male: 5 female • Age • Median 50.2 • Range 29-72 • BMI • Median 25.6 • Range 23.4-36.1 • 8 white:5 asian:1 a/c • 11 HD: 2 CAPD: 1 Pre • 11 CTx: 1NHBCTx: 2 LDTx • 4 died with functioning graft • 3 recurrent FSGS • 2 rejection • 2 RVT • 1 RAT • 1 CMV • 1 PTLD and rejection Out of 7 Out of 17

  19. Deaths • 60 F, BMI 24, Asian, HD (Shrews) • CTx 7/5/10, CIT 14h, 67y donor • Re-explored 11/5/10 for bleeding • Segmental infarcts on graft • ITU admission with sepsis • Sepsis – MOF –death on 15/5/10 (day 8)

  20. 72 M, BMI 26.9, White, CAPD (RHH) • CTx 4/12/10, CIT 13h50m, 43yr donor • CMV colitis in month 2 • Became unwell • RIP 4/2/11 (day 62) • 66 M, BMI 30.9, White, HD (BHH) • CT 4/11/10, CIT 20h41m, 53yr donor • Conservative Mx of retroperitoneal bleed • Severe HZV infection • RIP 4/12/11 (day 30)

  21. 69 F, BMI 24.5, White, Pre (NSRI) • CTx 1/8/10, CIT 11h50m, 69yr donor • PTLD (EBV –ve pre Tx) • RIP 25/10/10 (day 86)

  22. Points from this Audit • All deaths in patients over 60yrs • Next talk • High proportion of Asian Graft Loss • High FSGS recurrence rate (43%) • Currently auditing greater time period • Low Live Donor numbers • Hospital move – already addressed

  23. Acknowledgments • Mr Mellor • Mr Inston • Mr Krishnan • Mr van Dellen • Dr Tomlinson • Sr Oliver

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