Trust Today June 2011 FINAL.pdf - Bradford Teaching Hospitals ...

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HOW NIGEL FOUND THE ABILITY TO GIVE Nigel James is the Foundation Trust’s surgeon who carries out corneal transplants. Until recently, Yorkshire had one of the worst eye donation rates. We don’t know the reasons why, but over the past year this has improved significantly following discussions with the families of those people who donate solid organs after their death. Communications officer, Tanya Tarry, talks to the man who is helping to give Bradford’s eye patients the gift of sight. For Nigel James life has come full circle. The son of a Keighley woman who was brought up in Zimbabwe and South Africa, he only discovered his Yorkshire roots when family told him about his mother’s heritage upon hearing that he was taking up a post in Bradford back in 1996. Now as Consultant Ophthalmologist at the Bradford Royal Infirmary for more than 15 years, he says: “I suppose you could say that I’ve gone full circle but there is something quite strange about completing the circle without any intention to do it.” A section of the cornea which will be used in the deep lamellar transplant (where three of the five front layers are used). He first became interested in giving people sight while working in Namibia as a young doctor fresh out of medical training in Cape Town in the 1980s. “I started working in the eye department and initially it started off as something I enjoyed doing but then I became attracted to eye surgery because it is very precise, intricate surgery. “I really enjoyed it and felt that I could make quite a difference to people’s lives as a lot of the population lived away from the towns, had lost vision later in life, and just accepted it so to be able to help them see again was just astounding. Most assumed that they would just go blind so to regain their sight meant the world to them … and to me.” Nigel took up his post in the city after spells of training in Nottingham, Windsor, Reading and Leeds. He specialises in corneal abnormalities, anterior segment and cataracts. But it is his skill in eye surgery which makes him the Foundation Trust’s only corneal transplant surgeon. The shortage of organs in the UK means that NHSBT (blood and transplant) only supplies the hospital with one cornea donation The transplant box in which the cornea was transported to the hospital in. Eye surgeon Nigel James every time he carries out a surgical list. He performs two lists a week. “There is a great need to increase donation as we are restricted to one patient a list, which is a situation replicated throughout the country, but if we only had more corneas we could transplant more people and bring down our waiting times,” says Nigel in a soft Zimbabwean accent. There is a great need for eye transplants in Bradford. “We have an eye problem which is unique to Bradford because our south Asian population has four times the rate of keratoconus seen in other areas of the county,” adds Nigel. Keratoconus is a condition where the cornea becomes thin and then distorts – 20 per cent of patients will need a corneal transplant, usually in both eyes. “No one knows why this is more prevalent in the city, it can be inherited, but in the vast majority of people that we see it appears to be isolated cases within families.” The next largest group in need of corneal transplants in Bradford are those eye patients suffering from Fuchs Corneal Dystrophy WEEK OF SPECIAL EVENTS Come to our AGM You are invited to come along to our Annual General Meeting being held on Wednesday, September 14 from 1 to 2pm in the Sovereign Lecture Theatre. There will also be an opportunity to hear formal presentations including an outline of our priorities for this year and our successes over the last. Summaries of our Annual Report and Accounts will also be available to collect on the day. Come to our Open Event Visit our stalls for some interactive fun and celebrate the achievements of staff showcasing some excellent examples of their healthcare work and patient care. Nominate a Trust Star for our Hospital Oscars Nominations will open soon for this year’s Hospital Oscars where we celebrate teams and individuals right across the Foundation Trust. This is a tremendous 10 Trust Today | June 2011
THE GIFT OF SIGHT (people have less cells in the inside of their cornea which leads to swelling), followed by patients with trauma to the eye and finally patients with corneal ulcers (a condition more common in patients who wear contact lenses as they can be susceptible to eye-lid disease). Recent technological surgical advancements have transformed the way surgeons like Nigel carry out eye transplants. Five years ago, the whole cornea had to be replaced and sewn in situ using 16 sutures (stitches) a tenth of the thickness of a human hair. Nowadays operations have been revolutionised and there are various types of corneal transplants where the various layers of the cornea are replaced rather than the whole lens. “We used to have one operation but now, thanks to keyhole surgery, there are different types of corneal transplant, from a full-thickness transplant (where all five layers of the cornea are used) to a deep lamellar transplant (where three of the five front layers are used). “We try not to remove the two inner layers of the cornea as they are usually responsible for rejection, so if we can keep the patient’s own healthy cells, then we would rather leave them. This technique is usually used on keratoconus patients, but not always. “Finally Dsek (Descemet’s Stripping Endothelial Keratoplasty) is where we transplant the inner two layers of the cornea. Patients with Fuchs tend to have this operation as there is often a problem with a number of cells. With this operation, the transplanted cornea is held in place, not with stitches, but with an air bubble which is syringed into place in the eye and then reabsorbed back into the body within 24 hours.” Patients have to lie on their backs for an hour to position the transplant as the patient has no stitches, just a two and a half millimetre incision. A corneal transplant takes between 60 minutes and an hour and a half to carry out. Unlike other major organ transplants where recipients take anti-rejection drugs for the rest of their lives, after a year most cornea transplant patients will not need to take immunosuppressants, which come in the form of eye drops. “To some extent the eye is a protective site,” adds Nigel. “Because the cornea lacks blood vessels so the rejection rate reduces as time passes.” The waiting list for a cornea transplant is currently nine months but in neighbouring areas this can be almost doubled. Unlike other organ donations, the majority of corneas don’t need to be tissue-matched, unless the patient has had a number of failed grafts then matching will be considered. Likewise, corneal transplants don’t have to be matched to race or blood type. For safety reasons, only one cornea is replaced at a time because if an infection sets in the patient could lose their sight. This is the position for all eye operations. In Bradford the oldest recipient has been 96-years-old while the youngest has been 14. “The other thing which is different to the norm in cornea transplantation compared to major organ donations is that older donors can give sight to very much younger patients,” said Nigel. “Older people might think, well if I am 70 and donate my eyes, they won’t use them, but actually this is not the case and corneas from those of advanced age can be used for much younger patients. “I would say to people reading this piece and thinking about not donating their eyes after their death, that the gift of sight is incredible and it is an incredible thing to be able to give someone else.” A deep lamellar transplant Transplants save lives. To join the NHS Organ Donor Register: ■ go to www.organdonation.nhs.uk ■ call 0300 123 23 23 ■ text SAVE to 84118 testimony to the hard work of staff and the quality of the care we provide. Entries need to be in by September 1 so now is the time to plan what you want to say and who you want to nominate for individual Oscars or Team of the Year. Both award ceremonies are possible thanks to the generous sponsorship of Sovereign Health Care, which is working in partnership with the Trust to support the awards. For more information about the Oscars or Team of the Year contact Head of Corporate Affairs, Jo Bray, via groupwise email. Downloaded nomination forms will soon be available on the staff intranet. Staff Quiz Held on the Thursday night, the staff quiz is an ever-popular event for employees. To book your table please contact PA Sheridan Osborne on 4794 or send an email. Friday Night Finale Back by popular demand the Friday Night Finale will feature live bands, food and dancing. More details will follow so keep an eye out on the announcements section of the staff intranet on how to obtain tickets for this event. Trust Today | June 2011 11
Page 1 and 2: Bradford Teaching Hospitals NHS Fou
Page 3 and 4: Following the integration of BACHS
Page 5 and 6: BORN IN BRADFORD’S FOURTH ANNUAL
Page 7 and 8: Artist’s impression of what the n
Page 9: In the last edition of Trust Today
Page 13 and 14: SAFE HAVEN FAX MACHINES By Rebecca
Page 15 and 16: BRADFORD HOSPITALS SOCIAL CLUB NEED
Page 17 and 18: E-ROSTERING ROLLOUT CONTINUES ACROS
Page 19 and 20: GOES LIVE! We are very pleased to a

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