Transplant First

Measurement platform

The KQuIP Transplant First project includes a data collection tool, which allows data collection for your involvement. Its primary use is for you to be able to identify patterns and reasons why patients are not listed for transplantation pre-emptively. In this way you can use it to improve quality in your unit. To maximise usefulness there should be clinical involvement and feedback to your local team.

In the future, the data will also be collated by the Renal Registry so that trends over time can be identified- you will have access to this along with the other units in your region who have agreed to share this data as part of the project.

There are 3 parts to the data collection

• Dialysis Starters Data- This is an expansion of NHS England Renal Indicator 3 - Access to Transplantation and looks at patient starting dialysis and whether they were listed at that point
• Transplant Listing Data- This look at all patients who were listed in a quarter, and when they were listed in relation to starting dialysis
• Transplant Activity Data - this is some additional data about the number of transplants for your renal unit patients

Measurement example

Using the transplant first data tool to identify areas for improvement. One unit found that the numbers of pre-emptive transplants (that is, people receiving a kidney transplant as their first renal replacement therapy) had started to drop, even before the impact of the COVID pandemic. The team looked at the charts, were able to identify that a large reason for this drop in numbers was that patients had been referred for assessment when there eGFR was less than 15 – a late referral.

The two charts below show the data used:By identifying this as a reason for the reduction in pre-emptive transplant listing, the team are able to concentrate their efforts on identifying patients sooner and referring them to the transplant team before their eGFR is less than 15.