Monthly variance in UK renal transplantation activity: a national retrospective cohort study
Objective To identify whether renal transplant activity varies in a reproducible manner across the year.Design Retrospective cohort study using NHS Blood and Transplant data.Setting All renal transplant centres in the UK.Participants A total of 24 270 patients who underwent renal transplantation bet...
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BMJ Publishing Group
2019-09-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/9/9/e028786.full |
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| author | David W Ray Robert Maidstone Hannah J Durrington Marcus Lowe Kay Poulton Judith Worthington David van Dellen Argiris Asderakis John Blaikley Titus Augustine |
| author_facet | David W Ray Robert Maidstone Hannah J Durrington Marcus Lowe Kay Poulton Judith Worthington David van Dellen Argiris Asderakis John Blaikley Titus Augustine |
| author_sort | David W Ray |
| collection | DOAJ |
| description | Objective To identify whether renal transplant activity varies in a reproducible manner across the year.Design Retrospective cohort study using NHS Blood and Transplant data.Setting All renal transplant centres in the UK.Participants A total of 24 270 patients who underwent renal transplantation between 2005 and 2014.Primary outcome Monthly transplant activity was analysed to see if transplant activity showed variation during the year.Secondary outcome The number of organs rejected due to healthcare capacity was analysed to see if this affected transplantation rates.Results Analysis of national transplant data revealed a reproducible yearly variance in transplant activity. This activity increased in late autumn and early winter (p=0.05) and could be attributed to increased rates of living (October and November) and deceased organ donation (November and December). An increase in deceased donation was attributed to a rise in donors following cerebrovascular accidents and hypoxic brain injury. Other causes of death (infections and road traffic accidents) were more seasonal in nature peaking in the winter or summer, respectively. Only 1.4% of transplants to intended recipients were redirected due to a lack of healthcare capacity, suggesting that capacity pressures in the National Health Service did not significantly affect transplant activity.Conclusion UK renal transplant activity peaks in late autumn/winter in contrast to other countries. Currently, healthcare capacity, though under strain, does not affect transplant activity; however, this may change if transplantation activity increases in line with national strategies as the spike in transplant activity coincides with peak activity in the national healthcare system. |
| format | Article |
| id | doaj-art-6deaa3db55274e0487314c0ca6a6c973 |
| institution | DOAJ |
| issn | 2044-6055 |
| language | English |
| publishDate | 2019-09-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-6deaa3db55274e0487314c0ca6a6c9732025-08-20T02:49:22ZengBMJ Publishing GroupBMJ Open2044-60552019-09-019910.1136/bmjopen-2018-028786Monthly variance in UK renal transplantation activity: a national retrospective cohort studyDavid W Ray0Robert Maidstone1Hannah J Durrington2Marcus Lowe3Kay Poulton4Judith Worthington5David van Dellen6Argiris Asderakis7John Blaikley8Titus Augustine93 Sir Jules Thorn Sleep and Circadian Neuroscience Institute, University of Oxford, Oxford, UK3 Oxford Centre for Diabetes, Endocrinology and Metabolism, University of Oxford, Oxford, UKFaculty of Biology, Medicine and Health, School of Biological Sciences, Division of Immunology, Immunity to Infection & Respiratory Medicine, The University of Manchester, Manchester, UK1 Transplantation Laboratory, Manchester University NHS Foundation Trust, Manchester, UK1 Transplantation Laboratory, Manchester University NHS Foundation Trust, Manchester, UK1 Transplantation Laboratory, Manchester University NHS Foundation Trust, Manchester, UK2 Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK7 Cardiff Transplant Unit, University Hospital of Wales, Cardiff, UKDivision of Infection, Immunity and Respiratory Medicine, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UKDepartment of Renal and Pancreatic Transplantation, Manchester University NHS Foundation Trust, Manchester, Greater Manchester, UKObjective To identify whether renal transplant activity varies in a reproducible manner across the year.Design Retrospective cohort study using NHS Blood and Transplant data.Setting All renal transplant centres in the UK.Participants A total of 24 270 patients who underwent renal transplantation between 2005 and 2014.Primary outcome Monthly transplant activity was analysed to see if transplant activity showed variation during the year.Secondary outcome The number of organs rejected due to healthcare capacity was analysed to see if this affected transplantation rates.Results Analysis of national transplant data revealed a reproducible yearly variance in transplant activity. This activity increased in late autumn and early winter (p=0.05) and could be attributed to increased rates of living (October and November) and deceased organ donation (November and December). An increase in deceased donation was attributed to a rise in donors following cerebrovascular accidents and hypoxic brain injury. Other causes of death (infections and road traffic accidents) were more seasonal in nature peaking in the winter or summer, respectively. Only 1.4% of transplants to intended recipients were redirected due to a lack of healthcare capacity, suggesting that capacity pressures in the National Health Service did not significantly affect transplant activity.Conclusion UK renal transplant activity peaks in late autumn/winter in contrast to other countries. Currently, healthcare capacity, though under strain, does not affect transplant activity; however, this may change if transplantation activity increases in line with national strategies as the spike in transplant activity coincides with peak activity in the national healthcare system.https://bmjopen.bmj.com/content/9/9/e028786.full |
| spellingShingle | David W Ray Robert Maidstone Hannah J Durrington Marcus Lowe Kay Poulton Judith Worthington David van Dellen Argiris Asderakis John Blaikley Titus Augustine Monthly variance in UK renal transplantation activity: a national retrospective cohort study BMJ Open |
| title | Monthly variance in UK renal transplantation activity: a national retrospective cohort study |
| title_full | Monthly variance in UK renal transplantation activity: a national retrospective cohort study |
| title_fullStr | Monthly variance in UK renal transplantation activity: a national retrospective cohort study |
| title_full_unstemmed | Monthly variance in UK renal transplantation activity: a national retrospective cohort study |
| title_short | Monthly variance in UK renal transplantation activity: a national retrospective cohort study |
| title_sort | monthly variance in uk renal transplantation activity a national retrospective cohort study |
| url | https://bmjopen.bmj.com/content/9/9/e028786.full |
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