ESPN 53rd Annual Meeting

ESPN 2021


 
Reducing face to face outpatient visits for Renal Transplant patients….Virtually impossible?
LOUISE KIPPING 1 HELEN JONES 1 GRAINNE WALSH 1 NICK WARE 1

1- GUYS AND ST THOMAS HOSPITAL
 
Introduction:

For half a century, paediatric renal transplant recipients (pRTRs) have been exclusively followed up in face to face(F2F) clinic in our tertiary centre. During the COVID-19 global pandemic adaptations were made to minimise travel/exposure for all pRTRs by re-structuring the clinic and utilising local services, for monitoring traditionally carried out by the tertiary centre. A virtual(video) transplant clinic overseen by the paediatric transplant team was developed together with postal packs to enable immunosuppression drug level and viral load monitoring in conjunction with laboratory colleagues.

Material and methods:

Retrospective review of F2F versus virtual pRTR outpatient follow-up appointments 6 months before the COVID-19 pandemic , after 6 months and 1y into it in a single paediatric nephrology centre. 

Results:

97 pRTRs under follow up included in the study. Due to COVID-19 the transplant program was suspended for a period where no new pRTRs were added to the cohort until the end June 2020.

Median number of reviews per pRTR was 5 F2F and 0 virtual before, 3.5 F2F and 2 virtual 6 months into and 3 F2F and 2 virtual 1 year into the pandemic. To facilitate the virtual reviews pRTRs had monitoring blood tests, anthropometry, blood pressure and urinalysis at the tertiary centre (57%), in primary care (15%), children’s community nursing team (14%) and at their local hospital (12%).

Conclusions:

Developing a virtual transplant clinic enabled a reduction of F2F visits during the COVID-19 pandemic. We hope to further develop this service by strengthening our links with local services as well as empowering pRTRs and families to carry out some of their own monitoring (weight, blood pressure, urinalysis and finger prick blood tests) in the home environment and evaluate the outcome including patient feedback of these changes.