Covid-19 has affected many types of care and procedures offered by the NHS, including renal transplantation. After a period of brief suspension, we have restarted the transplant programme in a safe manner and are proud to have designed a pathway with patient involvement.
This case study summarises the reflections of two patients who underwent a donor nephrectomy (live kidney donation) and renal transplant recently.
Joe and Frances Clancy are a retired couple who recently attended The Royal London Hospital for a kidney transplant.
Frances was first diagnosed with renal failure in 2002, where she was in and out of hospital for several months.
Having recovered and lived through this for many years, Frances’ kidney functionality kept on decreasing, and it was agreed that Joe would step forward to provide a kidney as he was passed as a suitable candidate for the donation.
Taking place on Tuesday 21 July, the transplant involved Joe, 68, donating his kidney to his wife, Frances, 63, as her kidney function had reached the critical point of 11 per cent.
The couple have even produced a video diary which documents their experience.
The transplant was due to take place earlier this year, with Frances’ kidney function reaching the critical point in February. However, due to the covid-19 pandemic, all transplant surgery was suspended meaning the couple would have to wait.
After being paused at the start of the pandemic, planned procedures have now restarted across all specialties. Our teams are contacting patients to book them in for surgery, starting with the most urgent cases.
Once the transplant programme was ready to resume, the couple received a call in late June with their surgery date and were provided with extensive information about the infection control measures in place to keep them safe.
“Although surprised at first, we quickly decided that now was actually a good time for the transplant”, said Joe.
“We were talked through the actual process of live donor transplantation by one of the team of surgeons in late June, who then told us what extra measures would be taken by the hospital and by us to ensure a safe and Covid-free experience.
"This took place over the phone, as opposed to a face-to-face consultation and was extremely informative.”
A major part of welcoming patients back and the resumption of services in hospital is ‘zoning’, meaning Covid and non-Covid patients are cared for in separate parts of the hospital.
In the lead up to their surgery, Joe said: “They told us that the hospital would create a ‘green area’ for surgery and preoperative tests; staff here would not work in other areas of the hospital to avoid contamination and they would be regularly tested to check they had not contracted the virus.
"After speaking with the live and recipient transplant co-ordinators over the phone, we then went to the hospital on July 7 for all the usual pre-operative tests as well as a Covid swab.
"We then had to shield for two weeks before the operation. We were not worried about the threat of the Covid-19 virus as we were satisfied that every precaution had been taken and all eventualities planned for carefully.
"We felt reassured by the transplant team’s honest approach after discussing the process and risks involved."
Despite being one of the first kidney transplants in the programme to resume after the Covid-19 pandemic, the couple underwent their surgery and are expected to make a full recovery.
Since the operation, Frances’ kidney function has improved more than 50% and she is enjoying a new lease of life with more vigour and energy.
Of their surgery, Joe described his appreciation for Royal London Hospital staff: “Throughout this process we have been impressed, not just with the skill and professionalism of the medical practitioners who supported us, but also with their care and concern for us as people.
"We are happy with the measures put in place by the hospital to maintain that vigilance, and that everything possible has been done to minimise the risk.”
The transplant team are delighted with the couple’s progress and have since performed more renal transplants from live and deceased donors.
Barts Health NHS Trust’s hospitals have been adapting the way they operate so staff can continue to treat and care for patients safely while Covid-19 remains a threat to everyone’s health.