Hospital temporarily halts kidney transplants after Covid admissions spike

Richard Vernalls, PA
·4 min read

England’s largest hospital trust has called a temporary halt to kidney transplants as its doctors and nurses cope with an influx of Covid-19 patients.

The University Hospitals Birmingham (UHB) NHS Trust had already said earlier this week it was having to “significantly” scale up in-patient and critical care capacity, in a bid to avoid being “overwhelmed” by coronavirus admissions.

The trust also said all planned procedures would be stood down at its main site, the Queen Elizabeth Hospital, Birmingham, while elective surgery and outpatient services would be reduced at Solihull Hospital, as staff were redeployed.

Kidney transplants are now being paused because of increased risk to patients, a lack of bed space, and the need to redeploy doctors and nurses to frontline wards, in the latest service to feel the knock-on effect of spiking Covid admissions.

NHS Blood and Transplant (NHSBT), which oversees transplantation and organ donation across the UK, said it was working with regional centres to “ensure no opportunity for transplant is missed”.

It said transplants “continue to be a priority across the NHS” and that it was working with regional colleagues “to continue with deceased organ donation and transplant activity as much as possible”.

UHB, which operates four hospitals including Birmingham Heartlands and Good Hope in Sutton Coldfield, was dealing with 873 Covid-positive in-patients and a further 125 in intensive care units (ICU), on Tuesday.

Its chief executive Dr David Rosser said earlier in the week there had been 80 coronavirus admissions alone on Sunday.

Coronavirus – Wed Apr 8, 2020
Dr David Rosser said the UHB Trust admitted 80 Covid positive patients on Sunday (Jacob King/PA)

Announcing a 14-day halt of renal transplant services on Thursday, hospital bosses said they did so with “regret” and apologised to affected patients.

Data from NHSBT showed liver transplants at the QE were only open for “super urgent” patients on a case-by-case basis, while cardio-thoracic transplants, for heart or lungs, were only open to “super urgent and urgent” cases.

Kidney transplants were also closed at The Royal London Hospital, West London Renal & Transplant Centre, and the Queen Alexandra Hospital in Portsmouth, according to the NHSBT website.

Meanwhile, The Royal Free Hospital, London, is closed to liver transplants, and Cambridge’s Addenbrooke’s Hospital is only open to “super urgent” cases, because of coronavirus.

The West London Renal and Transplant Centre, Guy’s Hospital, London, and Churchill Hospital, Oxford, are also closed to pancreas transplants.

The move by UHB comes after Peter Hewins, a consultant at the trust, set out the scale of the unprecedented challenge now facing frontline medics, calling it “one of extremis”.

“We are at significant risk of becoming overwhelmed by Covid-19 patient[s] and specifically our ICUs are under immense pressure,” he said in an email to colleagues.

Total ITU capacity at the trust is set to be scaled up to 280 beds, with more than 200 at the main QE site alone – and 200 doctors deployed to critical care from other departments, as soon as the end of the week.

Remarking that it was a “period of absolute emergency”, Mr Hewins said: “We have no other options… We must now stand together to face the full force of [the third] wave of the pandemic.”

The trust now has significantly more patients with Covid in its hospitals than it did during the first peak in April last year, with an expectation among bosses those numbers will continue rising for some time.

In a statement UHB confirmed it had had to “temporarily pause its kidney transplantation programme due to Covid-19”.

A trust spokeswoman said the situation would “remain under review” and staff would be directly contacting affected patients.

“We regret that any procedure has to be postponed and can only apologise to those affected,” she said.

“We recognise it is distressing for patients whose elective care does need to be rescheduled, however we must always ensure that the care we provide is safe.”

John Forsythe, NHSBT’s organ donation and transplantation medical director, said: “We have learnt a lot from the first and second waves of the virus and transplants continue to be a priority across the NHS, with safety remaining paramount.

“The wider clinical team work closely together with the shared aim that no opportunity for transplant is missed.

“When certain centres have come under pressure, or report that they are unable to transplant organs, the key is to ensure that there will be other centres around the country who are able to sustain transplantation services.

“If an organ is declined by one centre due to capacity, we have systems and procedures in place to identify a suitable alternative centre to ensure that the organ can still go to a patient in need.”