+ West Midlands Transplant Audit and Education Event 5 th July - PowerPoint PPT Presentation

+ West Midlands Transplant Audit and Education Event 5 th July 2015 Dr Kerry Tomlinson Clinical Service Lead and Consultant Nephrologist, University Hospitals North Midlands NHS Trust

Housekeeping  Wi-Fi is available and so is Twitter @WMSCN #transplant  Photography  Toilets  Fire Alarm  Refreshments & Lunch  Feedback form  RCP CPD accreditation  Please switch phones to silent  Packed agenda so please stick to the timings

Figure 3.2. Median eGFR in prevalent transplant patients by centre on 31/12/2014 UK Renal Registry 18th Annual Report

Figure 3.3. Percentage of prevalent transplant patients by centre on 31/12/2014 with eGFR <30 ml/min/1.73 m 2 UK Renal Registry 18th Annual Report

Figure 3.5b. Median eGFR one year post-brainstem death donor transplant by transplant centre 2007 – 2013 UK Renal Registry 18th Annual Report

Figure 3.5c. Median eGFR one year post-circulatory death donor transplant by transplant centre 2007 – 2013 UK Renal Registry 18th Annual Report

Figure 3.7a. Median haemoglobin for prevalent transplant patients with eGFR > 30 ml/min/1.73 m 2 by centre on 31/12/2014 UK Renal Registry 18th Annual Report

Figure 3.8b. Percentage of prevalent transplant patients with eGFR <30 ml/min/1.73 m 2 achieving haemoglobin > 100 g/L by centre on 31/12/2014 UK Renal Registry 18th Annual Report

Figure 3.10a. Percentage of prevalent transplant patients with eGFR > 30 ml/min/1.73 m 2 achieving blood pressure of <130/80 mmHg by centre on 31/12/2014 UK Renal Registry 18th Annual Report

+ Data: What will we achieve? (What will success look like) 95% of all CKD 5 patients will have a documented transplant decision West Midlands will achieve >95% patients starting RRT with a transplant status > 50% of patients will be listed pre-emptively The West Midlands will have the highest rate of pre- emptive listing in the UK The wait for deceased donor kidneys in the West Midlands will be in line with the national average or better We will be in the top 50% of transplant units for pre- emptive transplants

+ CKD 5 with documented decision  2 units no data  Others range form 0-100%

+ Patients starting RRT with transplant status

+ Patients starting RRT Unsuitable Listed Suspended No documented decision Working up or under discussion

+ Causes of “No documented decision” Unsuitable but not documented Delays in system DNA Medically Complex No reason given Common reasons given for delays: Hub and spoke Failing transplant

+ Causes of “Working up or under discussion” Late referral Medically complex DNA Unsuitable but not documented Delays in system No reason given Note: in last return commonest cause was late referral

+ Data: What will we achieve? (What will success look like) 95% of all CKD 5 patients will have a documented transplant decision West Midlands will achieve >95% patients starting RRT with a transplant status > 50% of patients will be listed pre-emptively Current rate of The West Midlands will have the highest rate of pre- pre-emptive emptive listing in the UK transplants 23% The wait for deceased donor kidneys in the West Midlands will be in line with the national average or better We will be in the top 50% of transplant units for pre- emptive transplants

+ Where next  I think we need to focus on data core to project  Discuss with Units who are not using dashboard  Think about what we want to Audit next year