Time to rethink refusing kidney transplants for obese patients

Time to rethink refusing kidney transplants for obese patients.

Audit: time to rethink

Editorial Audit: time to rethink Doctors carry out 20,000 audit projects each year. This will have cost the NHS £834 million by the end of the century.1 What is the benefit to patients? Most clinicians would immediately reply "very little". The NHS Executive is more guarded in reply, but, tellingly, has commissioned more research on the value of audit. The NHS Audit Initiative was formally laun...

Time to rethink continuity.

Continuity of care is a value that lies at the very heart of family medicine. It is one of those powerful, traditional values of general practice that we have accepted as being at the centre of our discipline. It refers to a continuous relationship between one physician and one patient over an extended period. It sometimes involves contact through many illnesses and life challenges. Research ha...

Kidney transplantation in patients with history of malignancy: Time to rethink the guidelines?

A history of malignancy is often considered a contraindication for kidney transplantation. While the desire to transplant a 'cancer-free' patient is understandable, the current approach neglects the heterogeneity in the natural history of cancers, even within a given tumor type. The information used to formulate current guidelines are dated and fail to reflect the vast resource of modern oncolo...

Is it time to rethink combined liver-kidney transplant in hepatitis C patients with advanced fibrosis?

AIM To reduce hepatic and extrahepatic complications of chronic hepatitis C in kidney transplant recipients. METHODS We conducted a systematic review of kidney only transplant in patients with hepatitis C and advanced fibrosis. RESULTS The 5 year patient survival of kidney transplant recipients with and without hepatitis C cirrhosis ranged from 31% to 90% and 85% to 92%, respectively. Hepat...