1 Leadership, planning and service organisation

1 Leadership, planning and service organisation

1.1 Regional renal networks should work with NHS commissioners and NHS Blood and Transplant to manage the renal transplant pathway and use a network approach to supporting deceased and living donor transplantation. This includes:

  • ensuring that there are COVID‑19‑secure sites or areas for:

    • transplant recipient and donor assessment

    • transplantation and donation

    • follow-up after transplantation

    • ongoing care for all patients with a transplant

  • reviewing assessment pathways for transplant recipients and living donors

  • considering alternative sites for parts of the pathway (while following Human Tissue Authority guidance for transplant centres considering using different premises).

1.2 Before re-opening or expanding a transplant programme, centres should be confident that:

  • appropriate internal and external governance arrangements are in place, including arrangements for data collection and reporting

  • they can meet normal service specification requirements on staff, facilities and equipment

  • they have access to rapid turnaround testing for SARS‑CoV‑2

  • they can care for transplant recipients and donors in COVID‑19‑secure areas during inpatient stays

  • they and the associated non-transplanting centres can carry out assessment and follow-up, minimise risk (see communication and minimising risk), and provide COVID‑19‑secure areas as needed.

1.3 Transplant centres should discuss plans to re‑open, expand or transfer patients to another centre with:

1.4 Transplant centres should tell patients and living donors (and their families and carers, as appropriate) about their re-opening and expansion plans, and discuss transfers with them.

1.5 Transplant centres should review donors and patients on the waiting list, taking account of the risks and benefits for them in the context of COVID‑19. Discuss this with each donor and patient and their families and carers (as appropriate). Make decisions as part of a multidisciplinary team, and in conjunction with NHS Blood and Transplant and NHS commissioners.

1.6 Transplant and non-transplanting centres should make arrangements to use local services for investigations where possible.

1.7 Transplant and non-transplanting centres should use remote phlebotomy services to minimise face-to-face contact.

1.8 Transplant and non-transplanting centres should consider SARS‑CoV‑2 testing for patients on the waiting list who do not have symptoms of COVID‑19, in line with local policies.

1.9 Transplant and non-transplanting centres (as appropriate) should tell NHS Blood and Transplant and the Renal Registry about transplant recipients and patients on the waiting list who have COVID‑19.

1.10 If testing capacity is available, transplant and non-transplanting centres (as appropriate) should offer SARS‑CoV‑2 testing to frontline staff who do not have symptoms of COVID‑19, in line with local policies.