Selection of kidneys for transplantation.

UK : University of London, 1974.

1 encoded moving image (31 min.) : sound, black and white

00:31:26

University of London

Unrestricted

CC-BY-NC

Creative Commons Attribution-Non-Commercial 2.0 UK: England & Wales

In English

Presented by Mr. Robert A. Sells, Director, Renal Transplant Unit, Liverpool Royal Infirmary. Produced by David Sharp.

This video is one of around 310 titles, originally broadcast on Channel 7 of the ILEA closed-circuit television network, given to Wellcome Trust from the University of London Audio-Visual Centre shortly after it closed in the late 1980s. Although some of these programmes might now seem rather out-dated, they probably represent the largest and most diversified body of medical video produced in any British university at this time, and give a comprehensive and fascinating view of the state of medical and surgical research and practice in the 1970s and 1980s, thus constituting a contemporary medical-historical archive of great interest. The lectures mostly take place in a small and intimate studio setting and are often face-to-face. The lecturers use a wide variety of resources to illustrate their points, including film clips, slides, graphs, animated diagrams, charts and tables as well as 3-dimensional models and display boards with movable pieces. Some of the lecturers are telegenic while some are clearly less comfortable about being recorded; all are experts in their field and show great enthusiasm to share both the latest research and the historical context of their specialist areas.

Segment 1 Mr Sells introduces the subject and discusses a chart that shows the system that matches donated kidneys with patients who have renal failure. A table shows the number of transplants performed in 1973. Sells says that the object of this programme is to highlight the severe shortage of kidneys needed for transplants. He explains what makes a good donor, and what does not, with the aid of tables listing the donors' causes of death. Time start: 00:00:00:00 Time end: 00:06:29:20 Length: 00:06:29:20

Segment 2 Sells discusses the problem of ensuring that a deceased donor patient is totally brain dead before beginning with a transplant. He runs through the criteria of brain death and an image of The Human Tissue Act of 1961 is shown. He discusses the procedures for obtaining permission for organ transplantation from next of kin and the coroner. Time start: 00:06:29:20 Time end: 00:12:11:00 Length: 00:05:41:05

Segment 3 Sells discusses the next stage, the removal of kidneys from the donor. A photograph of a kidney is shown as Sells discusses the conditions needed for a successful operation. He then describes the storage of the kidney once it has been removed. He also describes, with the aid of a table, the attention that the donor should receive before their artificial respirator is turned off. The drugs they receive are listed. Time start: 00:12:11:00 Time end: 00:18:33:14 Length: 00:06:22:14

Segment 4 Sells also discusses the importance of the donor's heart to remain beating prior to removal of the kidneys. He says that this may sometimes be a controversial issue but lays out the reasons why he believes that a donor's heart should be allowed to beat although they are about to be pronounced dead. He then shows a chart showing the results of 90 transplants in correlation to the delay between the removal and transplant. There is no correlation between this time and success. He talks about a technique being developed in Liverpool that looks at chemical phenomena in kidneys to determine whether they will function in a transplant. Time start: 00:18:33:14 Time end: 00:23:39:15 Length: 00:05:06:01

Segment 5 Sells explains that due to methods used in England, a procedure is needed where a small piece of kidney is tested to determine whether it will function upon transplantation. A chart of a normal case study is shown. He describes the technique of using potassium loss and sodium gain to study the kidney tissue. A film clip of a kidney biopsy is shown. Sells describes what happens in the film. Time start: 00:23:39:15 Time end: 00:27:42:00 Length: 00:04:02:10

Segment 6 Sells explains what happens to the small kidney biopsy next and how the viability test works. A chart showing results of the tests on 24 patients is discussed. Sells says that this test is useful. Sells sums up his lecture by stressing the need for more kidneys and the need to improve the supply of kidneys. Time start: 00:27:42:00 Time end: 00:31:26:01 Length: 00:03:44:01