Dear Sir,
At a recent National Kidney Federation Council meeting concern was expressed at the inequalities occurring nationally in the monitoring and treatment of skin problems, experienced by renal transplant patients.
They are often only advised on protection against skin cancer after a transplant and such advice is limited to the wearing of protective clothing and the use of a high factor sun block.
The National Kidney federation represents the interest of over 30,000 renal patients across the United Kingdom and the following proposals were passed unanimously:
Renal Units should be encouraged to:-
As you are no doubt be aware due to their drug regime, renal transplant patients are very prone to skin infections, ranging from fungal infections, moles, warts, solar kerotoses and tumours. Although not all problems are potentially cancerous, patients need to be made aware of the danger, and take appropriate action to protect themselves as much as possible. In order to achieve this it is strongly recommended a continuous programme of body checks be provided.
Additionally there are types of cancer caused by viruses which are a particular problem after kidney transplantation. In particular skin cancer, lymphoma, and cervical (neck of womb) cancer in females.
Statistically Renal Transplant patients are three times more likely than any other persons to suffer from skin cancer after a transplant. Provided skin cancers are diagnosed in good time, the prognosis is good since this type of cancer does not usually spread to other parts of the body and they can be relatively easily removed.
Patients’ need to be made aware of the risks, through literature and educational programmes. Those with a long functioning transplant really need a lifelong systematic follow up to ensure any complications are diagnosed at an early stage.
This should form part of an on-going care plan and be fully supported by a multidisciplinary team as appropriate. There are wide variations across the country at present, and regrettably few examples of best practice. The model implemented at Hammersmith is regarded as one example of best practice to follow.
There is a need to develop a national guideline based on best practice to ensure transplant patients’ receive the education and care needed. The renal National Service Framework currently being developed may be an appropriate vehicle to carry this forward.
May we ask for your support to ensure this subject receives the urgent attention and financial backing it deserves.
The National Kidney Federation requests consideration be given for all renal units to provide the appropriate level of care to ensure the proposals outlined above can be achieved.
Yours sincerely
Gordon Nicholas
Chairman — National Kidney Federation
The National Kidney Federation cannot accept responsibility for the views expressed by others in these letters pages.
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Last updated: 8 February 2008
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