Bristol surgeon completes his 1,000th kidney transplant

Thursday, 30 April 2009

Surgeon Paul Lear has spent 30 years giving his patients a new lease of life but he is now marking a milestone of his own - his 1000th kidney transplant.
His latest patient Rosemary Temple is currently recovering from surgery at Southmead Hospital in Bristol.
Mrs Temple, from Highcliffe near Christchurch in Dorset, said: "Mr Lear and the team were absolutely wonderful.
“I was very surprised when he told me I was his 1,000th kidney patient. I suggested having a party to celebrate but Mr Lear joked perhaps we should wait until after the operation.

“It’s really incredible what Mr Lear can do with the team here at Southmead – they perform miracles as far as I’m concerned.
“I couldn’t believe it was my turn when the phone rang and my partner said they had a donor kidney – we got here as quickly as we could and within a few short hours I was in theatre.
“Mr Lear has given hope and new life to a thousand people and I can’t thank him and the rest of the team enough.”

Mrs Temple said as a result of her operation she was now planning to take her first holiday in years with a trip to Paris.
Mr Lear said: “She seemed very happy that I had done this 999 times already.
“There are probably only a two or three surgeons in the country who have achieved 1,000 kidney transplants so I do feel proud to be in such company.”

Mr Lear was also honoured recently by the British Transplant Society at their annual dinner; he said: “They seemed to be very amused that I was still keeping score but that just shows you how much of a fanatic I am.”
Over the course of his career, Paul has seen a dramatic increase in the number and the effectiveness of kidney transplants - which he attributes to advances in drugs and improvement in the quality of patient management.
In 1979, the likelihood of a transplanted kidney functioning after one year was around 45 percent - today this number has risen to over 90 percent.
The number of transplants has also increased; Mr Lear used to carry out one or two transplants from live donations a year - today he carries out about 45.
For the last 18 years Mr Lear has been as a consultant transplant surgeon at Southmead Hospital, where he has helped pave the way for transplants between spouses – in particular where donor and recipient are not matched for tissue type and blood group.
This work means that today North Bristol NHS Trust has one of the biggest spousal transplant programmes in the UK.
Mr Lear said: “It was always possible to do transplants between people who aren’t related, but the outcome wasn’t always good.
“Now, new drugs mean results are better than those from transplants where kidneys are from deceased donors who are a perfect match.
“The majority of donations today are taking place between husband and wife – it’s seen as an ideal way to proceed because both donor and recipient benefit from the procedure.

“These kind of transplants are only undertaken between a pair of people when it’s unlikely a second transplant will ever be needed.”
Mr Lear’s work also extends beyond Bristol as, since 2004, he has travelled to Kano in Nigeria three times to mentor the development of an indigenous live donor kidney transplant programme.
He will be returning in June to carry out a refresher course to help local surgeons with more complex cases.
Sonia Mills, Chief Executive of North Bristol NHS Trust, said: "I am delighted for Mr Lear that he has reached such an historic milestone.
"I am especially pleased so much of his work has been achieved at Southmead Hospital and has benefited patients outside the big hospitals in London.
"I would like to wish Mr Lear continued success with the work that he and the team here at North Bristol NHS Trust undertake with such dedication."

Paul Lear’s biographical details:
Mr Lear qualified in 1975 in London and trained in the Midlands before moving to the United States.
From 1981 to 1983, he worked for Professor Nicholas Tilney in Boston at the Brigham Hospital, where the first successful live donor transplant was performed in 1956.
His transplant experience started in earnest on returning from the USA, when he went to work at the Royal Liverpool Hospital in Merseyside.
He moved to Barts in London in 1985 to provide most of the transplant service delivery, despite only being a senior registrar at the time.
He continued to support the transplant service at Barts on appointment to consultancy in 1988. By the time Mr Lear left Barts, he had performed 280 kidney transplants.
He began work at North Bristol NHS Trust’s Southmead Hospital in 1991.
Live donations are a planned procedure, where a person offers another person one of their kidneys. After they have undergone testing to make sure that they are suitable, the kidney is transplanted from one person into the other
Deceased donations fall into two categories: heart beating and non-heart beating donors. Heart beating donors are the most common form of organ donor, and occur when the donor remains ventilated until the kidney is removed (this usually from a massive brain haemorrage following a serious accident where the donor’s heart has stopped following withdrawal of supportive treatment). A non-heart beating donor occurs when the donor’s heart has stopped.