Northern Ireland

Kidney transplants suspended due to Covid fears and shortage of ICU beds

Covid pressures have overwhelmed the north's hospital system and led to dozens of cancelled operations, with warnings that patients' lives are at risk
Covid pressures have overwhelmed the north's hospital system and led to dozens of cancelled operations, with warnings that patients' lives are at risk Covid pressures have overwhelmed the north's hospital system and led to dozens of cancelled operations, with warnings that patients' lives are at risk

KIDNEY transplants have been suspended in Northern Ireland amid the devastating impact of the second Covid wave on hospitals.

Correspondence seen by The Irish News reveals that the transplant programme is "paused" at Belfast health trust - the regional base for the operations - because of coronavirus fears and demand for critical care at the specialist Nightingale hospital.

During the first lockdown, the trust was lauded for carrying out a record number of transplants - 101 in 101 days from mid-April - despite multiple staff redeployments and at a time when the majority of renal transplant centres closed across the NHS.

Patients on waiting lists have been left reeling by the latest news, with fears many will be forced to rely on dialysis treatment - itself often requiring surgery.

One patient said they were not just in physical pain as their kidney function deteriorated but were also struggling with the "mental anguish" the delay was causing amid the pandemic.

Read More: 26 further Covid-19 deaths across island as cases continue to mount

"When you have a transplant ready and have a live donor willing to donate, it's the gold standard treatment. I will have to go for an operation to have dialysis," they said.

"The situation is not evidence based, it's being dictated to by Covid. The transplant will be life-changing for me."

Exceptions will be made for cases where it is much harder to find a match, according to the November 5 letter written by the consultant overseeing the service.

Dr Damian Fogarty, clinical director of the regional nephrology and transplant unit at Belfast City Hospital, states that as well as hospital pressures, the risk of patients with severely weakened immune systems contracting the virus is a key factor leading to the "temporary cessation" of the service.

The development comes as the head of the Belfast health trust, Dr Cathy Jack, warned on Friday that non-Covid patients - including those with cancer and cardiac disease - who have major operations postponed are at risk of dying.

The letter is also signed by Dr Clodagh Loughrey, interim director of surgery as well as the trust's most senior doctor, medical director Dr Chris Hagan.

Sent to patients over the past fortnight, it states:

"It is with regret that we are writing to inform you that our kidney transplant programme in Belfast is currently temporarily 'paused', other than for 'highly sensitised' patients for whom it is extremely difficult to get a suitable match.

"This is due to increased pressure and demand in critical care in the Belfast Trust Nightingale hospital for Covid patients, as well as uncertainty about the potential risk of transmitting a virulent disease... to heavily immunosuppressed renal transplant recipients and otherwise healthy live donors.

"...A number of patients from the total of approximately 2,000 Northern Ireland patients dependent on either dialysis or a kidney transplant have been affected (by Covid-19). Some have had no symptoms whatsoever, some have needed to be in hospital with a more severe illness and a small number have very sadly died."

It adds: "We would like to reassure you we will recommence transplantation as soon as possible. The situation will be kept under weekly review."

The letter also says there will be no live donor transplants carried out "during this time".

Over the past decade, there has been a significant increase in the number of kidney transplants using organs from healthy people in Northern Ireland, rather than those who have passed away.

The success rate of such operations is very high, around 95 per cent, with Belfast last year described as a "world leader" in the field.

Sources say there is mounting concern among surgeons and those managing the service about the cancellations and "vagueness" around the timeframe for the suspension of operations using living donors.

Transplant surgery was initially stopped at the beginning of the pandemic but re-commenced in mid-April, when they carried out "two years of work" over a matter of months.

Surgeons and support staff worked round the clock, with the service relocating from its base at Belfast City Hospital to the Royal Victoria Hospital in what was hailed a "remarkable" achievement, with a third of all kidney transplants in the UK carried out in Belfast over a six-week period.

The operations included five kidney transplants in one 24-hour period, equalling a UK record.

The effort led to almost two-thirds of the north's kidney transplant waiting list being cleared, with just over 60 people on the list two months ago.

All 101 organs transplanted were from deceased donors.

In a statement last night, Belfast Trust echoed the regret expressed in the letter, citing the dangers of Covid transmission to vulnerable patients and "unprecedented critical care pressures in HSC Nightingale which has led to significant reduction in theatre staffing, impacting on surgery throughout the trust".

"A decision such as this is never easy - we fully understand the impact this will have on our patients and we sincerely apologise to every patient and family affected," it said.

"The decision will be reviewed weekly to ensure we can safely recommence the program at the earliest opportunity."

It added that it was "critically important" for every dialysis and transplant patient to closely follow all Covid precautions.

"All patients affected have been contacted and we would urge anyone with questions about their specific query to contact their consultant or the renal recipient coordinators."