scholarly journals Belatacept, kidney transplantation and COVID‐19: Successful management of the first reported case within the United Kingdom

2020 ◽  
Vol 34 (9) ◽  
Author(s):  
Syed Hasan Ahmad ◽  
Richard Smith ◽  
Brian Camilleri
Keyword(s):  
United Kingdom ◽  
Kidney Transplantation ◽  
Successful Management ◽  
The United Kingdom

scholarly journals Utilization and Outcomes of Single and Dual Kidney Transplants from Older Deceased Donors in the United Kingdom

2020 ◽  
Vol 15 (9) ◽  
pp. 1320-1329
Author(s):  
Maria Ibrahim ◽  
George H.B. Greenhall ◽  
Dominic M. Summers ◽  
Lisa Mumford ◽  
Rachel Johnson ◽  
...  
Keyword(s):  
United Kingdom ◽  
Kidney Transplantation ◽  
Propensity Score ◽  
Graft Survival ◽  
Propensity Score Analysis ◽  
Kidney Transplants ◽  
The United Kingdom ◽  
Score Analysis ◽  
Deceased Donors ◽  
Single Kidney

Background and objectivesKidneys from elderly deceased donors are often discarded after procurement if the expected outcomes from single kidney transplantation are considered unacceptable. An alternative is to consider them for dual kidney transplantation. We aimed to examine the utilization of kidneys from donors aged ≥60 years in the United Kingdom and compare clinical outcomes of dual versus single kidney transplant recipients.Design, setting, participants, & measurementsData from the United Kingdom Transplant Registry from 2005 to 2017 were analyzed. We examined utilization rates of kidneys retrieved from deceased donors aged ≥60 years, and 5-year patient and death-censored graft survival of recipients of dual and single kidney transplants. Secondary outcomes included eGFR. Multivariable analyses and propensity score analysis were used to correct for differences between the groups.ResultsDuring the study period, 7841 kidneys were procured from deceased donors aged ≥60 years, of which 1338 (17%) were discarded; 356 dual and 5032 single kidneys were transplanted. Donors of dual transplants were older (median, 73 versus 66 years; P<0.001) and had higher United States Kidney Donor Risk Indices (2.48 versus 1.98; P<0.001). Recipients of dual transplants were also older (64 versus 61 years; P<0.001) and had less favorable human leukocyte antigen matching (P<0.001). After adjusting for confounders, dual and single transplants had similar 5-year graft survival (hazard ratio, 0.81; 95% CI, 0.59 to 1.12). No difference in patient survival was demonstrated. Similar findings were observed in a matched cohort with a propensity score analysis method. Median 12-month eGFR was significantly higher in the dual kidney transplant group (40 versus 36 ml/min per 1.73 m2; P<0.001).ConclusionsRecipients of kidneys from donors aged ≥60 years have similar 5-year graft survival and better graft function at 12 months with dual compared with single deceased donor kidney transplants.

scholarly journals Inequity in Access to Transplantation in the United Kingdom

2020 ◽  
Vol 15 (6) ◽  
pp. 830-842 ◽  
Author(s):  
Rishi Pruthi ◽  
Matthew L. Robb ◽  
Gabriel C. Oniscu ◽  
Charles Tomson ◽  
Andrew Bradley ◽  
...  
Keyword(s):  
Health Care ◽  
United Kingdom ◽  
Kidney Transplantation ◽  
Confidence Interval ◽  
Odds Ratio ◽  
Practice Patterns ◽  
Universal Health Care ◽  
The United Kingdom ◽  
Universal Health Care System ◽  
Universal Health

Background and objectivesDespite the presence of a universal health care system, it is unclear if there is intercenter variation in access to kidney transplantation in the United Kingdom. This study aims to assess whether equity exists in access to kidney transplantation in the United Kingdom after adjustment for patient-specific factors and center practice patterns.Design, setting, participants, & measurements In this prospective, observational cohort study including all 71 United Kingdom kidney centers, incident RRT patients recruited between November 2011 and March 2013 as part of the Access to Transplantation and Transplant Outcome Measures study were analyzed to assess preemptive listing (n=2676) and listing within 2 years of starting dialysis (n=1970) by center.ResultsSeven hundred and six participants (26%) were listed preemptively, whereas 585 (30%) were listed within 2 years of commencing dialysis. The interquartile range across centers was 6%–33% for preemptive listing and 25%–40% for listing after starting dialysis. Patient factors, including increasing age, most comorbidities, body mass index >35 kg/m2, and lower socioeconomic status, were associated with a lower likelihood of being listed and accounted for 89% and 97% of measured intercenter variation for preemptive listing and listing within 2 years of starting dialysis, respectively. Asian (odds ratio, 0.49; 95% confidence interval, 0.33 to 0.72) and Black (odds ratio, 0.43; 95% confidence interval, 0.26 to 0.71) participants were both associated with reduced access to preemptive listing; however Asian participants were associated with a higher likelihood of being listed after starting dialysis (odds ratio, 1.42; 95% confidence interval, 1.12 to 1.79). As for center factors, being registered at a transplanting center (odds ratio, 3.1; 95% confidence interval, 2.36 to 4.07) and a universal approach to discussing transplantation (odds ratio, 1.4; 95% confidence interval, 1.08 to 1.78) were associated with higher preemptive listing, whereas using a written protocol was associated negatively with listing within 2 years of starting dialysis (odds ratio, 0.7; 95% confidence interval, 0.58 to 0.9).ConclusionsPatient case mix accounts for most of the intercenter variation seen in access to transplantation in the United Kingdom, with practice patterns also contributing some variation. Socioeconomic inequity exists despite having a universal health care system.

scholarly journals Ethnicity matching and outcomes after kidney transplantation in the United Kingdom

PLoS ONE ◽  
2018 ◽  
Vol 13 (4) ◽  
pp. e0195038 ◽  
Author(s):  
Bhavini Pisavadia ◽  
Adam Arshad ◽  
Imogen Chappelow ◽  
Peter Nightingale ◽  
Benjamin Anderson ◽  
...  
Keyword(s):  
United Kingdom ◽  
Kidney Transplantation ◽  
The United Kingdom

Obstetric emergencies

2020 ◽  
pp. 358-373
Author(s):  
Kiren Ghag ◽  
Cathy Winter ◽  
Tim Draycott
Keyword(s):  
United Kingdom ◽  
Significant Morbidity ◽  
Successful Management ◽  
Maternal Deaths ◽  
Multiprofessional Team ◽  
The United Kingdom ◽  
Team Working ◽  
Obstetric Emergencies ◽  
Maternal And Neonatal Outcomes ◽  
Late Recognition

Obstetric emergencies can be unpredictable and sudden, and may result in significant morbidity and mortality. Successful management requires a rapid coordinated response from multiprofessional maternity teams. In the recent Confidential Enquiry into Maternal Deaths in the United Kingdom, substandard care was identified in over 50% of cases and one-third of these could have been prevented with better care. Recurring problems were identified, including a lack of multiprofessional team working, poor communication, and late recognition of the severely unwell woman. Multiprofessional training for obstetric emergencies has been demonstrated to reduce intrapartum harm and improve maternal and neonatal outcomes. This chapter focuses on the immediate management of obstetric emergencies and is largely derived from the authors’ work with the PROMPT Maternity Foundation and the contents of the PROMPT.

KIDNEY TRANSPLANTATION IN THE UNITED KINGDOM

The Lancet ◽  
1982 ◽  
Vol 319 (8263) ◽  
pp. 88
Keyword(s):  
United Kingdom ◽  
Kidney Transplantation ◽  
The United Kingdom

scholarly journals Barriers to living donor kidney transplantation in the United Kingdom: a national observational study

2017 ◽  
Vol 32 (5) ◽  
pp. 890-900 ◽  
Author(s):  
Diana A. Wu ◽  
Matthew L. Robb ◽  
Christopher J.E. Watson ◽  
John L.R. Forsythe ◽  
Charles R.V. Tomson ◽  
...  
Keyword(s):  
United Kingdom ◽  
Kidney Transplantation ◽  
Observational Study ◽  
Living Donor ◽  
Donor Kidney ◽  
Living Donor Kidney Transplantation ◽  
The United Kingdom ◽  
Donor Kidney Transplantation ◽  
Living Donor Kidney

Factors Influencing Outcome After Deceased Heart Beating Donor Kidney Transplantation in the United Kingdom: An Evidence Base for a New National Kidney Allocation Policy

2010 ◽  
Vol 89 (4) ◽  
pp. 379-386 ◽  
Author(s):  
Rachel J. Johnson ◽  
Susan V. Fuggle ◽  
John OʼNeill ◽  
Samantha Start ◽  
J. Andrew Bradley ◽  
...  
Keyword(s):  
United Kingdom ◽  
Kidney Transplantation ◽  
Evidence Base ◽  
Donor Kidney ◽  
Allocation Policy ◽  
Kidney Allocation ◽  
The United Kingdom ◽  
Factors Influencing ◽  
Heart Beating ◽  
Donor Kidney Transplantation

En Bloc Kidney Transplantation From Paediatric Donors Under 2 Years of Age Including the Youngest Recorded Donor in the United Kingdom.

2014 ◽  
Vol 98 ◽  
pp. 588
Author(s):  
S. Pandanaboyana ◽  
I. Wijetunga ◽  
R. Bell ◽  
S. Farid ◽  
C. Ecuyer ◽  
...  
Keyword(s):  
United Kingdom ◽  
Kidney Transplantation ◽  
En Bloc ◽  
The United Kingdom
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