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What has Coventry done for Transplantation Rob Higgins

CoordinatorsNick West, Pat HartPlasmapheresis nursesKath McSorley, Razia Bibi, Pat CainHistocompatibility labDavid Briggs, Mark Hathaway, David LoweRed cell labIan Skidmore, Paul FleetwoodSurgeons and physiciansFT Lam, Habib Kashi, Chris ImrayPeter Roberts, Lam Chin TanAndrew Short, Simon

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What has Coventry done for Transplantation Rob Higgins

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    1. What has Coventry done for Transplantation? Rob Higgins

    2. Coordinators Nick West, Pat Hart Plasmapheresis nurses Kath McSorley, Razia Bibi, Pat Cain Histocompatibility lab David Briggs, Mark Hathaway, David Lowe Red cell lab Ian Skidmore, Paul Fleetwood Surgeons and physicians FT Lam, Habib Kashi, Chris Imray Peter Roberts, Lam Chin Tan Andrew Short, Simon Fletcher, Andy Stein Rizwan Hamer, Nithya Krishnan Pathology Klaus Chen, Alec Howie, Sari Suortami Vascular/Complement research Daniel Zehnder, Dan Mitchell

    3. What’s going on in Coventry? High transplant rate High success rate Antibody incompatible transplantation Europe’s largest programme Research ongoing

    5. Deceased donor transplants Allocation system up to 2006 non-white race half chance of transplant rare tissue type little chance transplant variation in transplant rate

    6. Deceased donor transplants UK Transplant allocation system 2006 Kidneys allocated nationally Coventry contributed to new scheme research into transplant allocation

    9. ‘Standard’ Transplants 2002-6 100 consecutive transplants 100% success

    10. 100 Transplants 19 ‘uncomplicated’ 81 had complications 23 rejection episodes 26 viral infections 13 bacterial infections in blood no MRSA

    11. What are antibodies? Natural defence Very nasty Remember who you are and hit you harder next time

    12. Antibodies and transplantation

    13. Antibodies and transplantation

    14. Antibodies and Transplantation 1 in 4 people on transplant list have antibodies against tissue types 250 transplants are stopped each year because of antibodies against living donor

    15. Antibody removal 1970-1995 Various attempts to remove antibodies 1995-2000 Success with living donor transplants in USA, Johns Hopkins University Since 2003 Coventry largest unit in Europe West London; Stockholm; Vienna Johns Hopkins and Mayo clinic in USA Several units in Japan have done more

    16. Antibody removal

    17. Antibody levels

    18. 2003-2007 130 people assessed Scotland, Wales, Ireland, all over UK 50 entered programme 93% patient survival 95% graft survival

    20. The First to…. Transplant immediately after antibody removal Measure antibody levels daily Recognise rejection resolved when antibodies still present Develop improved new method to measure blood group antibodies

    21. Ongoing research How are antibodies produced? What antibody subclasses are present? How does the kidney get damaged? What are the best drugs?

    22. Special thanks Walsgrave Kidney Patient Association Shurvintons and Kidney Kabaret Stratford patients group Other donors everyone else – especially the patients!

    23. Summary Coventry has contributed to Increased transplant rates Better allocation of transplants ‘Transplanting the untransplantable’ with a lot more very exciting research in the pipeline

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