Transplant Surgery

The Transplant Surgery Section aims to:

• participate in workforce assessments to ensure the workforce for Transplant Surgery in Australia and New Zealand is adequate;
• promote professional and community awareness and acceptance of organ and tissue donation for transplantation, and
• promote research in the basic and clinical sciences related to transplantation.

Scientific and education programs are run each year at the Annual Scientific Congress (ASC).

Transplant webinar series 

In 2023, the transplant section will be putting on a series of webinars that will address clinical surgical scenarios in transplantation. They aim to increase visibility of transplant groups and the nature of work that they do. The monthly seminars will be on a Monday night, from 7pm to 8pm AEST.  

Past Seminars

Monday, March 6th, 2023: Obesity and Kidney Transplant

Obesity has been increasingly prevalent in patients with end stage of kidney disease and is a barrier of wait list for kidney transplant. Transplantation seems to offer a survival benefit with significant reduction in mortality when compared with those remaining on dialysis, although it is known that obesity is associated with wound complications and DGF. Bariatric surgery has played an important role to facilitate obesity candidates to access kidney transplantation. In this Webinar, Dr. Ian Michell, a bariatric surgeon and transplant surgeon from the Austin hospital, will give an overview of current management of obesity and kidney transplant. The session was chaired by Dr. Bulang He.

Monday, February 6th 2023: Autosomal dominant polycystic kidney disease (ADPKD) and the transplant surgeon

ADPKD patients constitutes a significant number that presents to the transplant surgeon. This can be for renal transplantation, access surgeries, nephrectomies for symptomatic large polycystic kidneys, for creating space for transplantation, unexplained Deep vein thrombosis, Pulmonary embolism, intra cranial aneurysms and so on.  This presentation will cover intra cranial artery aneurysm and need for screening MRI and will move on to an interactive session on the various surgical challenges we face with this patient group when addressing some of the above issues. This will help the transplant surgical community to compare management strategies and modify practice when dealing with these patients.

Monday, 5th December 2022: RACS Transplant Section Presents: Out-of-hospital-cardiac-arrest donation after circulatory determinant of death donor and risk of delayed graft function & impacts of obesity on kidney transplantation, Dr Adam Philipoff.

DCDD donor kidneys represent an increasing proportion of overall kidney transplants in Australia. Approximately 1 in 3 controlled DCDD kidney donors experienced an out-of-hospital-cardiac-arrest (OHCA). OHCA donors may suffer a significant duration of cardiac downtime and tolerated an unknown period of warm ischaemia to the organs – potentially affecting donor organ quality.  Our objective was to compare the risk of Delayed Graft Function in recipients of controlled DCDD kidneys who had experienced OHCA compared to recipients of controlled DCDD kidneys without a prior history of OHCA.

AND

Kidney transplantation is certainly the treatment of choice in end-stage renal failure patients. The availability of these life-saving organs does not match the increasing demand of medically complex patients that may benefit from kidney transplantation.  An increasing proportion of transplant candidates are now classified as obese. How best to manage these patients remains uncertain – with variable practice among Transplant units globally. Understanding the influence of obesity on: recipient evaluation, perioperative risks and complications, as well as post-transplant outcomes, is critical to ensuring equitable access to renal transplantation to this growing comorbid population.

Monday, 7th November 2022: RACS Transplant Section Presents: Dual Kidney Transplantation – Too good or double trouble? Chaired by Dr Thomas Hanna.

Extended criteria donors are becoming more common. Dual kidney transplant (DKT) is one tool to expand the donor pool, utilizing organs which might otherwise have been discarded. However, evidence of outcomes is scarce and there is no consensus on DKT allocation. 

We present our unit experience of DKT, comparing outcomes with a matched cohort of single kidney transplant (SKT) patients. This seminar is presented by Charlotte Hitchins, Transplant Fellow at Auckland City Hospital. The session will be chaired by Thomas Hanna, Consultant Transplant Surgeon.

Monday, 3rd October 2022: Effect of perioperative blood transfusions on kidney transplant, Dr Nauman Ahmed and Dr Konrad Feng

Blood transfusions during and after kidney transplantation is a contentious topic. Whilst blood transfusions can cause immune reactions contributing to risk of rejection and sensitization, they may be need as lifesaving procedure. The 21^st century has seen improvement in immunosuppression and our understanding of blood transfusions. Given that 40-60% of kidney transplant recipients require post-operative blood transfusions, it is pertinent to know whether there are any consequences for graft survival and patient outcomes. This seminar is co-presented by Dr Nauman Ahmed/Dr Konrad Feng (MD students) and co-chaired by Prof Henry Pleass/Dr Animesh Singla.

Monday 5th September 2022: Caesarian sections in transplant patients, Dr Calvin Peng.

With restoration of fertility after kidney transplants, more female recipients are successfully completing pregnancies.  We report a case of injury to the transplant kidney during a Caesarian section to increase awareness and suggest techniques to avoid potential dangers. The session will be chaired by Dr Nancy Suh. 

Monday 1st August 2022: To Transplant or Not to Transplant: Clinical Outcomes for High-KDPI Kidneys in Australia and the role of Transplant Surgeons in Decision Making, Dr Emma Tully

With the increased acceptance of older, co-morbid and DCD donors, there has been marked variability in the quality of deceased donor organs.  Despite advances in machine perfusion, determining which organs should or should not be transplanted is not an 'exact science'.  In this forum, we will present the clinical outcomes of transplantation with marginal (high-KDPI) kidneys in Australia, and discuss the role of donor and transplant surgeons in identifying factors which may modify the risk of a poor recipient outcome.  We will conclude with a brief discussion around accessing Australia-wide databases (ANZDATA and ANZOD) for transplantation and donation research.

Monday 4th July 2022: Wound complications in renal transplantation - prevention and treatment, Dr Tariq Cachalia

The benefits of renal transplantation have been extended to a greater number of candidates in the past few decades. This included patients who are obese, have diabetes and other risk factors for wound-related complications. Wound complications impose a major burden on the patient and health care system. However, the long-term benefits of transplantation can be immense in the at-risk population. In this presentation Dr Tariq Cachalia, renal transplant fellow at RPA hospital in Sydney, will discuss how to avoid, identify and manage wound-complications in the renal transplant recipient. The session will be chaired by Dr Jerome Laurence.

Monday 6th June 2022: Liver re-transplantation – when and how to optimize organ allocation, Dr Valerie See 

Overall, re-transplantation represents around 6-7% of all transplants and even higher number can be seen in different condition, like auto-immune hepatitis and PSC. It poses a major challenge from organ allocation and patient selection to surgical difficulties and recipient outcomes for surgeons, hepatologists, anesthetists and intensivists. These are usually malnourished patients with previous operations and many medical comorbidities. The role of the transplant surgeon in patient selection, organ allocation and outcomes are of utmost importance, even more nowadays with the increasing number of patients in the waiting list and the shortage of organs. Here in Dr Valeri See, our HPB and Liver Transplant Fellow will describe the Victorian Liver Transplant Unit – Austin Hospital experience with redo liver transplantation.

Monday 4th April 2022: Clinical Outcomes of Dual Organ Transplants, Dr Peter Yoon 

There are challenges in work-up, surgery and peri-operative care for patients undergoing dual-organ transplants such as heart-kidney, liver-kidney and dual kidney transplants.  In this review, we assess the clinical outcomes of patients who have had dual organ transplants and host a broad discussion regarding the topic.
Dr Peter Yoon, the current fellow of Transplant Unit at the Princess Alexandra Hospital, will present a 10-year retrospective review on this topic.  The session will be chaired by Dr Handoo Rhee, Urological and Transplant Surgeon.

Monday January 31st 2022: Royal Adelaide Hospital presents: elective ureteric stenting and post-transplant ureteric complications

We will commence the series with a presentation from the Royal Adelaide Hospital transplantation unit. This unit undertakes kidney, solid organ pancreas, pancreatic islet transplants and dialysis access surgeries.The seminar will be presented by Dr Zhihong Kuah, a registrar who has been working in this unit for the last two 2 years. He will discuss evolving practices in renal transplant surgery and present the units experience with selective ureteric stenting and post-transplant ureteric complications. Dr Kuah’s 20-minute presentation will be followed by 40 minutes of discussion, chaired by Dr Santosh Olakkengil, where participants will have the chance to ask questions through an interactive clinical session and contribute their own knowledge and experiences.We encourage all with an interest in transplant surgery to come along and participate.

Organ Transplantation from Deceased Donors Consensus Statement on Eligibility Criteria and Allocation Protocols
Surgical Technique for Deceased Donor Abdominal Organ Procurement
PFET Program in Transplantation Surgery

If you are interested in becoming a member, please forward your details to the Secretariat.

The Section is governed by a Committee as per the Sections Terms of Reference (PDF 177.86KB) reporting to the RACS Fellowship Services Committee.

Committee Chair - Dr Bulang He FRACS

Contact: Transplant@Surgeons.org

Transplant Surgery Section Secretariat
Royal Australasian College of Surgeons
250-290 Spring Street
East Melbourne VIC 3002 Australia

Telephone: +61 3 9276 7407
Fax: +61 3 9276 7432
Email: transplant@surgeons.org