Note: there was a bug adding 1 hour to the cold ischaemic time during British Summer Time. This now been fixed but might produce some odd results if this form is used outside the UK time zone.
Recipient: {{age}} {{sex}} with {{ckd_stage}} due to {{primary_renal_diagnosis}} on {{dialysis_modality}} at with a failing transplant, referred from referred from {{referring_unit}}.
Donor: {{donor_age}} {{donor_sex}} {{donor_type}} , CHI {{donor_chi}} following {{cause_of_death}}. ODT number {{odt_number}} and EOS hospital code {{eos_hc}}. {{kidney_side}} kidney retrieved by {{retrieval_team | titlecase}} NORS team. {{kidney_side}} kidney retrieved by {{donor_nephrectomy}} donor nephrectomy by {{donor_surgeon}}. Perfused in situ with {{retrieval_perfusion_fluid}}. HTA Form A {{hta_a_number}}. WLST at {{wlst_time | date:'HH:mm'}}, cardiac arrest at {{cardiac_arrest_time | date:'HH:mm'}}, Crossclamp at {{crossclamp_time | date:'HH:mm'}}, Renal artery clamped at {{renal_art_clamp_time | date:'HH:mm'}}, cold perfusion at {{cold_perfusion_time | date:'HH:mm'}}.
Histocompatibility: Blood group {{donor_abo}}{{donor_rh}} to {{recipient_abo}}{{recipient_rh}}. HLA mismatch {{mismatch}}. Recipient cRF {{crf}}%. {{xm_type}}. {{immunology_comments | sentence}} {{induction}} induction. Methylprednisolone given prior to reperfusion. CMV {{donor_cmv}}/{{recipient_cmv}}. EBV {{donor_ebv}}/{{recipient_ebv}}.
Backbench: {{kidney_side}} kidney {{perfusion_quality}} with normal renal anatomy. and the anatomy was abnormal: {{renal_anatomy_description}}. There was retrieval damage: {{renal_damage_description}}. No visible retrieval damage. Perfused on backbench with {{backbench_perfusion_fluid}}, batch {{perfusion_batch}}. See separate backbench operation note.
Incision: Curvilinear modified Gibson's in the {{op_side}} iliac fossa. Inferior epigastric vessels in the rectus sheath ligated in continuity with 2/0 Polysorb and divided.
Procedure: Retroperitoneal space developed by sweeping peritoneum cephalad and medially. Spermatic cord slung and protected. Round ligament {{round_ligament_divided}}. {{iliac_vessels_comments | sentence}} The external iliac artery then vein were dissected under control with slings until mobile for their full lengths.
Venous anastomosis: Kidney out of ice at {{out_of_ice | date:'HH:mm'}}. End-to-side anastomosis using a caval tube to {{venous_anastomosis}} with {{venous_anastomosis_suture}} sutures using {{venous_technique}} technique. Vein crossclamped with venous bulldog, then EIV clamp released and suture tied. The suture was tied and clamp left on the EIV until the arterial anastomosis complete. The suture was tied after reperfusion of the kidney.
Arterial anastomosis: Arteriotomy with {{punchSize}} aortic punch into {{arterial_anastomosis}}. {{reconstruction | firstcap}} to achieve single end for anastomosis. {{short_patch_technique | sentence}} End-to-side anastomosis of {{renal_artery_prox}} to {{arterial_anastomosis}} with {{arterial_anastomosis_suture}} using {{arterial_technique}} technique. Second arteriotomy at {{arterial_anastomosis_2}} using {{punchSize2}} aortic punch and end-to-side anastomosis with {{arterial_anastomosis_suture_2}} using {{arterial_technique_2}} technique. Upper pole artery ligated with {{upper_pole_ligation}}. Lower pole artery anastomosis to inferior epigastric artery with {{lower_pole_inf_epi_technique}}. Reperfused at {{reperfused | date:'HH:mm'}} with {{reperfusion_quality}} perfusion despite strong pulse in renal artery. Intraoperative Doppler USS showed {{intraop_doppler_findings}}.
Ureteric anastomosis: The kidney was seen to be producing urine before the ureteric anastomosis was formed. No urine output was seen before ureteric anastomosis done. The bladder was distended with saline containing methylene blue. Anastomosis to {{ureteric_anastomosis}} over JJ stent using {{ureteric_technique}} technique with {{ureteric_suture}} continuous to urothelium and three interrupted {{bladder_suture}} to reapproximate bladder muscle.
Closure: {{drain | sentence}} Mass closure with {{fascial_closure}} sutures. Fascia left open to preserve renal perfusion. {{local_anaesthetic}}. {{local_anaesthetic_vol}}ml {{local_anaesthetic_drug}} locally infiltrated. Scarpa's fascia closed with {{scarpas_closed}} 2/0 Polysorb. Skin closed with {{skin_closure}}.
Clinician USS performed at end of operation and demonstrated {{postop_doppler_findings}}.
Peritoneal dialysis catheter removed at {{pd_catheter_removed}} by {{pd_removal}} technique. {{pd_suture}}. Exit site left to heal by secondary intention.
There was {{warm_ischaemic_time | date:'m'}} minutes primary warm ischaemia. There was no primary warm ischaemia. Total cold ischaemic time {{cold_ischaemic_time | date:'H' : 'UTC'}} hours and {{cold_ischaemic_time | date:"m"}} minutes. Anastomosis time {{anastomosis_time | date:'mm'}} minutes.
Post-op instructions: