1090 A UK-Wide Audit on Peri-Operative Practices During Deceased Donor Kidney Transplantation: Results from a Prospective National Transplant Access to Theatre (NTACT) Audit

Aim The outcomes of deceased donor kidney transplants are mainly affected by donor and recipient factors. There is little data on whether variations in perioperative practices could also affect the outcomes and there is also little data on the standard perioperative practices across the UK. This study aims to identify current perioperative practices from a prospective National Transplant Access to Theatre (NTACT) audit. Method A multicentre, prospective audit of adult deceased donor kidney-only transplants was conducted across 14 UK transplant centres from February to September 2022. Data collected via RedCap focused on pre-operative antibiotic use, surgeon's grade, post-operative destination, crossmatch, and advanced haemodynamic monitoring. Descriptive statistics were used for analysis. Results Among 476 kidney-only transplants, 29 were excluded, leaving 446 transplants for analysis. Pre-operatively, 98.4% received antibiotics, with co-amoxiclav (n=147), ciprofloxacin (n=92), and amikacin (n=69) being most common. Consultant surgeons led 91.7% (n=409) of operations, while consultant anaesthetists led 61.4%. Notably, central lines (67.7% n=302), arterial lines (44.2% n=197), and advanced hemodynamic monitoring (27.6% n=123) were employed. Goal-directed fluid therapy was administered in 71.7% (n=320) of cases, with 71.6% (n=229) using static parameters. Post-operatively, 76.9% (n=343) were sent to a transplant ward, while 9.4% (n=42) and 10.8% (n=48) were directed to the intensive care unit and high dependency unit, respectively. Conclusions This audit highlights significant variations in perioperative practices, prompting further exploration into their potential impact on postoperative outcomes such as graft function and mortality.