Benedict Lyle Phillips

• MB ChB BSc MSc MBA PhD FRCS
• Consultant Transplant Surgeon at Guy's and St Thomas' NHS Foundation Trust

Background The use of pre‐implantation kidney biopsies (PIKBs) to aid deceased donor kidney utilisation decisions is controversial. Outcomes of transplants that had been biopsied after the decision had been made to implant were analysed, in order to determine the association between chronic histological changes at implantation and graft outcomes....

Kidneys from donation after circulatory death (DCD) donors are utilized variably worldwide, in part due to high rates of delayed graft function (DGF) and putative associations with adverse longer‐term outcomes. We aimed to determine whether the presence of DGF, and its duration, were associated with poor longer‐term outcomes after kidney transplant...

Kidney transplantation is the optimal treatment for end-stage renal disease, but it is still severely limited by a lack of suitable organ donors. Kidneys from donation after circulatory death (DCD) donors have been used to increase transplant rates, but these organs are susceptible to cold ischemic injury in the storage period before transplantatio...

The use of uncrewed aerial vehicles (drones) has increased over the last decade. However, their application in healthcare has not been fully examined, in part, due to regulations preventing flight beyond the visual line of sight. This prospective randomised controlled laboratory study aimed to determine whether the in vitro quality of packed red bl...

Transplantation is the standard treatment for end-stage kidney disease but carries with it a non-trivial risk of post-operative complication. There is a need for a continuous, real-time, not additionally invasive method of monitoring organ perfusion. We present an approach to allograft perfusion monitoring using a human kidney model using ex vivo n...

Antibody incompatible transplantation (AIT) may be an only option for highly sensitized patients. Severe form of early antibody mediated rejection (AMR) adversely affects graft survival after AIT. The aim of this study was to identify individuals at risk of AMR. We analyzed 213 living donor AITs performed at our center. Among 120 ABOi, 58 HLAi and...

Introduction Ex-vivo normothermic machine perfusion (NMP) is a technique of preservation that can be used to assess the quality and suitability of a kidney for transplantation. This may prevent the unnecessary discard and increase the number of transplanted kidneys. Methods A total of 22 kidneys declined for transplant by all UK transplant centres...

Background Transplant rejection is a major cause of graft loss and morbidity. Currently, no human models of antibody-mediated rejection (AMR) exist, limiting mechanistic investigation and organ-specific targeted therapy. Here, using 12 human kidneys and ex-vivo normothermic machine perfusion, we demonstrate phenotypes of AMR after addition of antib...

Introduction Kidneys from donation after circulatory death (DCD) donors are more susceptible to cold storage (CS) injury and have a high risk of delayed graft function (DGF). This trial is the first to compare normothermic machine perfusion (NMP) to conventional CS in DCD kidney transplantation. Methods In a multicentre randomised control trial, D...

Kidney transplantation is the preferred treatment of end-stage renal failure for most patients suffering from this disease. Selected patients with renal failure due to diabetes also benefit from the combined pancreas and kidney transplantation. For most patients, transplantation has a higher incidence of death and morbidity in the short term, and i...

Background Postoperative acute kidney injury (AKI) is a common complication of major gastrointestinal surgery with an impact on short- and long-term survival. No validated system for risk stratification exists for this patient group. This study aimed to validate externally a prognostic model for AKI after major gastrointestinal surgery in two multi...

Simultaneous pancreas and kidney (SPK) transplantation, in uremic women with insulin‐dependent diabetes, increases the chance of a successful pregnancy and minimizes the risk to infants. The aim of this study was to document pregnancy and explore the challenges in this cohort of women. Retrospective analysis of women who underwent pancreas transpla...

Transplantation is the gold standard treatment for many patients with end-stage organ failure. In addition to the medical and surgical challenges in organ transplantation, the major biological barrier is immunological. This barrier may lead to graft rejection and loss. An understanding of transplant immunology is essential in order to care for tran...

Background: This study aimed to determine the impact of preoperative exposure to intravenous contrast for CT and the risk of developing postoperative acute kidney injury (AKI) in patients undergoing major gastrointestinal surgery. Methods: This prospective, multicentre cohort study included adults undergoing gastrointestinal resection, stoma rev...

Abstract Background Trainee research collaboratives (TRCs) have pioneered high quality, prospective ‘snap-shot’ surgical cohort studies in the UK. Outcomes After Kidney injury in Surgery (OAKS) was the first TRC cohort study to attempt to collect one-year follow-up data. The aims of this study were to evaluate one-year follow-up and data completion...

Introduction We assessed the effect of recipient body mass index (BMI) on the outcomes of renal transplantation and the management of obese patients with end-stage renal disease across the UK. Methods We analyzed data of 25539 adult renal transplants (2007–2016) from the UK Transplant Registry. Patients were divided in BMI groups [underweight: < 1...

BACKGROUND: Spinal cord ischemia (SCI) is a rare but devastating condition that can occur in the perioperative period resulting in paraplegia. Although diabetes mellitus is a risk factor for SCI in other types of major surgery, SCI is not widely recognized in transplantation. The aim of this study was to quantify the risk of spinal cord ischemia in...

Background Ex vivo normothermic perfusion (EVNP) technology is a promising means of organ preservation, assessment, and pre‐conditioning prior to kidney transplantation, which has been pioneered by a single group. We describe the challenges of setting up clinical EVNP programmes in two new centres, as well as early patient outcomes. Methods Govern...

The impact of the duration of delayed graft function (DGF) on graft survival is poorly characterised in controlled donation after circulatory death (DCD) donor kidney transplantation. A retrospective analysis was performed on 225 DCD donor kidney transplants between 2011 and 2016. When patients with primary non‐function were excluded (n=9), 141 rec...

Ureteroneocystostomy (UNC) is the implantation of the ureter onto the bladder. The indications for this are:Implantation of a donor ureter during renal allotransplantationRe-implantation of the native ureter during renal autotransplantation (a treatment for complex renal artery aneurysm)Re-implantation of the native or transplant ureter due to dise...

Background Mobile learning (mLearning) devices (such as tablets and smartphones) are increasingly part of the clinical environment but there is a limited and somewhat conflicting literature regarding the impact of such devices in the clinical learning environment. This study aims to: assess the impact of mLearning devices in the clinical learning e...

This is a case report examining a urine leak and ureteric stricture following pediatric dual en-bloc renal transplanta-tion. Despite intraoperative ureteric stenting, and post-operative nephrostomy, urinary leak continued. Both grafts grew in size from 5 cm at implantation, to 9.5 cm within 3 months. Ureteric reconstruction would expose the patient...

Kidney transplantation is recognised as the gold standard treatment of end-stage renal disease in most children, with excellent graft survival rates. When graft failure occurs, renal transplant recipients (RTRs) have the option of removal of the transplant (graft nephrectomy [GN]), or leaving the failed transplant in situ. The aims of this review a...

Transplantation is the gold standard treatment for many patients with end-stage organ failure. In addition to the medical and surgical challenges in organ transplantation, the major biological barrier is immunological. This barrier may lead to graft rejection and loss. An understanding of transplant immunology is essential in order to care for tran...