The St George's Kidney Patients Association is pleased to announce the donation of a Laparoscopic Stack to the St George's Renal Transplant team for use in their Live Donor Programme. This is largest single donation made by the charity for many years and the stack is a critical tool in the removal of kidneys from a live donor.

What is a Laparoscopic Stack?

A Laparoscopic Stack is a collection of equipment used in the performance of Laparoscopic surgery.

 

It provides

• robotic arms to assist the surgeon,
• a camera to film the surgery within the patient
• a large screen for viewing what the camera is filming,
• an inflator to provide space within the patient's abdomen
• recording and printing facilities to provide an audit trail of the operation

In the specific case of Renal Transplantation it is used to perform keyhole surgery on a live kidney donor to remove their kidney, prior to it being grafted to the recipient. The new system should provide a number of improvements over the previous system including:

• improved safety - The higher definition screen and camera allows even finer detail, including tiny blood vessels, to be seen by the surgeon
• more comfort for the patient - heated gas to inflate the abdomen rather than cold gas that chilled and meant it took a patient longer to wake from the anaesthetic.
• reduced operating time - the heated gas avoids the camera fogging and thus slowing the operation down while it is cleaned

Thank you from the Transplant Team

Please find attached a letter from the Live Donor Clinical Lead, Consultant, Sarah Heap. Click the image for the full wording.

 

About Transplantation and the Live Donor Programme at St George's

The Live Donor Programme was begun in 2005 by Mr Fronek, and now, under the clinical leadership of Ms Sarah Heap performed 44 operations in 2015 and hopes to reach 50 this year. As of November 2016, The unit has undertaken 505 live donor transplantations using the previous equipment (also donated 11 years ago by the St George's KPA).

Number of Transplant carried out at St George's

Year	DBD	DCD	Live	Total
2008	35	16	45	96
2009	25	11	47	83
2010	24	19	57	100
2011	29	12	48	89
2012	54	15	51	120
2013	66	39	40	145
2014	55	33	43	131
2015	55	30	44	129

Transplantation Outcomes at St George's

In 2015 according to the renal registry (the database of all renal units in the UK), St George's is achieving some of the best outcomes in the UK for transplantation among the 23 centres. These include:

• The best (shortest time) from removal to grafting (DBD donors) of the kidney - 10 hours (known as CIT - Cold Ischemic Time)
• The 3rd best (shortest time) for DBD donors, also 10 hours

Despite declining fewer kidneys than other units (2nd and 4th best nationally - DBD/DCD) they still achieve better than median survival rates for the new kidney and the patient receiving the kidney. These results for 2015 are in the table below:

DECEASED Donors

	After	St G's	National Median*		After	St G's	National Median*
Graft Survival	1 year	93%	94%		5 years	88%	86%
Patient Survival	1 year	98%	96%		5 years	94%	89%

*= The median is the middle point of a number set, in which half the numbers are above the median and half are below.

LIVE Donors

	After	St G's	National Median*		After	St G's	National Median*
Graft Survival	1 year	98%	97%		5 years	94%	92%
Patient Survival	1 year	99%	99%		5 years	99%	95%

*= The median is the middle point of a number set, in which half the numbers are above the median and half are below.

About the donation from the St George's Kidney Patient Association

The donation of over £50,000 is the largest donation that the charity has made to the renal unit. It represents more than a year of donations to the charity and comes from:

• Ticket sales and donations gathered at the Christmas Carol Concert and other events such as the 2015 Summer Ball
• Many generous donations in memory of patients
• Numerous enjoyable and adventurous fundraising events by patients, their friends and relatives, and staff
• Many donors making regular or one-off donations to the charity
• A number of legacy donations left in patient's wills.