Graham LipkinSeptember 23rd 2014

West Midlands Renal NetworkTransplant Education & Audit

Introduction

• The changing face of transplantation

• Access to transplantation in Wmids

Survival advantage of Renal Tx over dialysis

Wolfe RA. N Eng J Med 1999;341:1725-30

RR at 18months Predicted years life without Tx

Predicted years of life with Tx

All recipients 0.32 10 20

Survival advantage of Renal Tx over dialysis

Wolfe RA. N Eng J Med 1999;341:1725-30

RR at 18months Predicted years life without Tx

Predicted years of life with Tx

All recipients 0.32 10 20

Transplantation doubles length of lifeHealth economic benefits +++

Transplant Early-Pre-emptive Transplantation is Ideal

100

90

80

70

60

50

40

30

200 12 24 36 48 60 72 84 96 108 120

Months post-transplant

% event free survivalPre-emptive0–6 months6–12 months12–24 months24+ months

Meier-Kriesche et al. (2002)

Transplant Outcome-Timing

100

90

80

70

60

50

40

30

200 12 24 36 48 60 72 84 96 108 120

Months post-transplant

% event free survivalPre-emptive0–6 months6–12 months12–24 months24+ months

Meier-Kriesche et al. (2002)

Survival best if Transplant before dialysis or shortly after

UK Renal Registry 14th Annual Report

Transplantation Profile

Adult Kidney Transplants

Increasing Transplant Numbers

Wmids Transplant Access Rates: How do we compare?

Waiting Time for Deceased Donor Transplant

Pre-emptive Transplant Listing

Wmids Transplant Plan

• Designated transplant lead Consultant and nurse• Transplant list annual review• Review Live Donor and pre-emptive Tx listing

rates• Annual education & audit• Review post transplant quality markers• Share best practice