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Renal Medicine / Dialysis

Opening Hours: Monday - Saturday between the hours of 7.30am-6pm with a 2 shift system in place.
Contact:Amanda Charleton
Telephone:Tel: 020 7234 2261
Fax: 020 7234 2957
Email: amanda.charleton@hcahealthcare.co.uk

London Bridge Hospital’s dialysis unit relocated in May 2010 and our new bright and spacious unit offers high standards of care within a relaxed and friendly atmosphere. Our aim is to ensure that patients attending dialysis receive a seamless service, in a safe environment and in a timely manner.

The unit conduct weekly audits on cleanliness and customer satisfaction as well as infection rates. London Bridge Hospital had zero hospital acquired cases of MRSA bacteraemia in 2009 and all MRSA carriers are isolated.

The Dialysis unit operates Monday - Saturday between the hours of 7.30am-6pm with a two shift system in place and provision to stay open later if required. There is a 24 hour nurse and consultant on-call cover for acute emergencies. Patient appointments for Dialysis are between 07.30 – 09.30 am and 12.00 noon - 12.30 pm.

Bookings should be made 4 - 6 weeks in advance of travelling. Once you have made contact with us we shall send you the necessary documentation for completion.

CONTACT

Holiday Co-ordinator Tel: 020 7234 8284   Fax: 020 7234 2957
The Dialysis Team: 020 7234 2261 / 020 7234 2957
Email: amanda.charleton@hcahealthcare.co.uk

The renal service comprises of a multidisciplinary team and includes Renal Physicians (Nephrologists) Surgeons and Interventional Radiologists.  The Interventional Radiologists have the expertise required in the placement of renal dialysis catheters.

HOLIDAY DIALYSIS

London Bridge Hospital is the ideal location for holiday dialysis with a fantastic centralised location overlooking the River Thames and Tower Bridge.

The unit is within easy reach of the city, adjacent to London Bridge station and ample attractions on offer.
We provide dialysis for patients who are NHS sponsored as well as overseas visitors who are visiting the country for business or pleasure.

The unit also offers an isolation room and therefore we can accommodate patients who are Hepatitis B, C or MRSA positive. The room provides en suite and disabled facilities. For further information please contact the unit.

The unit offers:

1. Air conditioning
2. Comfortable reclining dialysis beds for maximum comfort
3. Complimentary fresh sandwiches and beverages
4. Wireless internet access

What to bring with you 

It is not necessary to bring any dialysis equipment. However, please ensure all medications are brought, especially those you take during dialysis, in particular Erythropoietin injections, alpha calcidol or any vitamin supplements.
If you use any other anticoagulation regime other than heparin sodium feel free to bring it with you or please inform us in advance so that we may be able to supply it.
Please also provide, prior to or on arrival at the hospital, copies of recent blood results. We will also require a contact address and telephone numbers whilst you are in the UK.

RENAL ACCESS AND TRANSPLANTION 

Introduction

Chronic kidney disease is an increasingly common problem and in the UK there are approximately 40,000 people with this condition who require some form of renal replacement therapy. Kidney transplantation offers a near normal existence and has been shown to improve survival and quality of life compared to dialysis therapy.

Dialysis Access Surgery

When the kidneys are not functioning properly the body accumulates waste toxins which you would normally excrete in the urine. Dialysis refers to a process of ‘cleaning the blood’ and this is necessary for many people with chronic renal failure.

The most important part of the whole procedure is how to remove the blood from the body. The best way of doing this is by creating a ‘fistula’. This normally involves an operation in one of your arms to join an artery and vein together to form a circuit of flowing blood. From this fistula circuit, the blood is circulated around the dialysis machine and the cleansed blood is returned to the patient.

The operation to form the fistula will usually take about one hour and can often be performed under local anaesthetic.

Kidney Transplantation

A kidney transplant is generally considered the best option for anyone with chronic renal failure-most people live longer than if they stay on dialysis and enjoy a better quality of life.

Your own kidneys can be found at the back of the abdomen and for most people with chronic renal failure the kidneys will shrink and do not need to be removed before a transplant. If however, they are causing problems e.g. pain, bleeding, infection etc then it may be necessary to remove them.

The transplant kidney is normally placed at the bottom of the abdomen, just above the hip. It is joined to the blood vessels which travel to the leg and also to the bladder. Blood passes through the kidney and is cleaned; urine is produced as a result of the cleaning process. The urine travels from the transplant kidney into the bladder and you pass it out in the normal way.

The kidney transplant operation takes 3-4 hours and most people are in hospital for a week in total. After you have left hospital it is vital that you attend the outpatient department regularly so that we can monitor the function of the new transplant.

If you have already had a transplant that failed it is possible to have another one. Normally this is placed on the opposite side to the first transplant.

Live Kidney Donation

The best form of kidney transplant is from a Live Donor. This is someone who is fit and willing to give you one of their kidneys. In the absence of a close relative the partner and/or close friend can be considered provided that they are medically or immunologically suitable.

Before they can donate a kidney we will perform a series of investigations on them to see that they are in excellent health and so the impact of the surgery and living with one kidney is minimal.

There are two methods of removing a kidney for transplantation. The traditional approach is to make a cut underneath the ribs and remove the kidney through this opening.

A newer method is to remove the kidney using 'keyhole' or laparoscopic surgery techniques. This method is less painful and allows for quicker recovery. For further information please see below

Laparoscopic Live Donor Nephrectomy

This is a new surgical technique which has been developed in the 1990's and is now recognised as the optimal way to remove a kidney for transplantation.

What are the advantages?

Compared with the traditional (open) approach, laparoscopic donation results in less pain, fewer days in hospital, a faster recovery and return to normal health. In particular, the larger patient will benefit considerably from the laparoscopic approach. Additionally, the scars are cosmetically improved.

Is everyone suitable for laparoscopic donation?

Laparoscopic surgery is recognised as being more complex than traditional surgery to remove a kidney. But our experienced surgeons are able to perform the laparoscopic operation in almost all patients.

What about the transplant?

There is no difference for the recipient between laparoscopic donation and traditional surgery. When performed by an experienced surgical team the donated kidney will have an excellent outcome for the recipient of the kidney, on average this form of transplant would last at least 15 years.

What about the donor’s remaining kidney?

Before anyone can donate a kidney, they must undergo a series of tests to make sure that there will be minimal risk to their long term health. Laparoscopic donation allows a faster recovery and does no harm to the remaining kidney. However, it is necessary for the donor to have a simple blood/urine test each year and have their blood pressure checked.

The Operation

Before Surgery

All potential donors must undergo a thorough evaluation of their health before they can undertake kidney donation. This is to ensure that they will recover from the operation well and their long term health (with one kidney) will not be affected.

As part of this process you will meet the surgeon who will perform the operation and he will talk to you in detail about how the operation will precede and what to expect afterwards. He will be delighted to answer any questions you have and reassure you over any worries.

Preparation for surgery

The day before the operation your surgeon will meet with you to check that everything is in order to proceed. If you are taking any medication, then continue this as normal. Eat and drink normally until midnight and then have nothing more once you have gone to bed. You will have a drip overnight which will stop you feeling thirsty and also ensures your kidneys are full of fluid before the operation.

The operation

The operation is performed under general anaesthetic and takes 3-4 hours. A camera and one or two small instruments are inserted through the side of the abdomen. These instruments are used to separate the tissues from around the kidney. The final part of the procedure is to divide and seal off the blood vessels. The kidney is then removed through an opening about the size of a hand below the umbilicus (belly button).

After the operation

Your surgeon will see you immediately after the operation. You can have something to drink straight away. Then you will return to the ward. The next day you will be out of bed and free from any drips etc. You can eat and drink as you feel like. Most people will leave the hospital on the third day after the operation.

After leaving hospital

Although the scars are small you will have had a major operation and your body will be recovering. Therefore, it is advised that you take it easy. Walking is recommended to speed your recovery but any strenuous exercise should be avoided. Your surgeon will review you again in the outpatient clinic in four weeks after the operation. Most people feel fully recovered at this point and are ready to return to normal life-driving, going back to work, resuming sporting activities etc.

Living Donor Kidney Transplantation at London Bridge Hospital

Our surgical team (Guy’s Hospital) is among the most experienced and successful in the UK to perform these operations.  They have over twenty years experience in managing all aspects of kidney transplantation (including Laparoscopic Live Donor Nephrectomy) and are able to deal with the most complex problems.