Projects

Research

Study Groups

Access to transplantation and transplant outcome measures (ATTOM)

Lead investigator:
Prof J Andrew Bradley
Prof Clare Bradley
Prof John Cairns
Dr Chris Dudley
Mr John Forsythe
Mrs Rachel Johnson
Dr Gerry Leydon
Dr Wendy Metcalfe
Mr Gabriel Oniscu
Dr Rommel Ravanan
Prof Paul Roderick
Mrs Ruth Summers
Dr Charlie Tomson
Mr Chris Watson

Project contacts:
Dr Rishi Pruthi, rishi.pruthi@renalregistry.nhs.uk

Start / End:
2011 - Ongoing

A National Institute for Health Research (NIHR) funded research programme supported by the Department of Health, the Renal Association, the British Transplantation Society, the UK Renal Registry, the Scottish Renal Registry and NHS Blood and Transplant. A non-interventional, prospective, cohort study that aims to recruit all patients aged less than 75 years starting dialysis, receiving a transplant and a similar number of matched patients active on the transplant waiting list, from all dialysis and transplant centres in the UK over a one year period.

Study Aims:

  • To improve equity of access to kidney and pancreas transplantation across the UK
  • To optimise organ allocation to maximise the benefit, including cost-effectiveness, from kidney and kidney-pancreas transplantation.

There are four related project work streams: To identify patient- & centre-specific factors that influence access to the transplant waiting list and subsequent access to transplantation.

  1. To identify patient- & centre-specific factors that influence patient survival on dialysis or after transplantation
  2. To evaluate patient-reported outcomes including quality of life (QoL) experienced by patients on dialysis or after transplantation
  3. To perform a health economic analysis of kidney and kidney + pancreas transplantation.
  4. To determine an optimal organ allocation policy to maximise clinical and cost benefits from transplantation, using survival, QoL and other patient-reported outcomes and Health economic data.

What is the research plan?

A trained research nurse based at the regional transplant centre will, after a short period of training (organised centrally), collect patient level data from case notes/ local information technology systems at your transplant centre and associated non-transplanting renal units (approx work load – 10-14 patients/week), and administer/deliver PROMs questionnaires to patients and coordinate their collection. Nurses will upload data in real time onto a completely secure web site. In parallel, Qualitative research in the form of interviews/questionnaires administered to key stake holders involved in renal/pancreas transplantation, will be undertaken to understand the centre specific factors that influence access to and outcomes after transplantation.

Why is the study important?

  • The first and largest prospective study of its kind anywhere in the world and will put UK transplantation at the international forefront in this area.
  • Will provide ‘real world’ clinical evidence base from the UK to influence policy decisions about UK renal transplant patients
  • Will provide unit level accurate bench marking for co-morbidity burden and transplant related resource availability allowing between unit comparisons of patient level and centre level factors that influence access to outcomes after transplantation
  • Allow development of a patient survival probability model to standardise access to transplantation in the UK
  • Enable the QoL and health economic gains from transplantation to be assessed and inform the development of alternative organ allocation algorithms.