The Evolution of St George’s Renal Unit 

In the early 1960s, individual London Teaching Hospitals were consulted on their views on taking on the new treatment of haemodialysis.  The Royal Free Hospital started treating patients in 1963 followed by Charing Cross Hospital in 1964.  Clinicians at St George’s Hospital, then at Hyde Park Corner, declined the offer.

In 1973, Peter Richards a Consultant Physician with a background in Renal disease, was appointed to St George’s Hospital [still at Hyde Park Corner]; he left in 1979 to become the Dean of St Mary’s.  After a gap of about a year with no Renal Physician, Dr John Eastwood was appointed as the first Consultant Renal Physician/Senior Lecturer in Medicine.  His appointment on July 1^st 1980 coincided with the final closure of St George’s Hospital at Hyde Park Corner on June 29^th 1980 when the last patients were transferred to the Tooting site.  Renal in-patient beds were provided at St James’s Hospital, Balham and remained there until St James’s closed at the end of August 1988.  Coincidentally, in the same month the first Specialist Nephrologist in Training, Dr Steve Morgan, was appointed as Senior Registrar.  On the closure of St James’s, all renal facilities and staff moved to St George’s Hospital, Tooting.

Once all renal facilities were on the single site at St George’s it was possible to develop facilities for haemodialysis and peritoneal dialysis.  The first patient was established on CAPD in October 1989, and the first on haemodialysis in August 1990. The first renal transplant was a live donation in  ?March 1991.  Patients with Acute renal failure [AKI: acute kidney injury] were treated in collaboration with Professor David Bennett in the main Intensive Care Unit.

Developments in Renal Medicine and Transplantation in London and the South-East

Specialty Reviews in 6 disciplines in London and the South-East were undertaken in 1993.  The disciplines were Renal Services [in essence transplantation], Cancer Services, Cardio-Thoracic Services, Neurosciences, Plastics/Burns, and services for Children.

The Review of Renal Services chaired by Dr Gillian Matthews was necessary because in the area consisting of London, Essex, Kent, Surrey and Sussex there were no fewer than 14 transplant units doing about 500 transplants a year, i.e. about 35 per unit; some units did under 20 a year.  This lack of surgical activity in the majority of units meant that it was not possible to train budding transplant surgeons.  At that time, in Southern England, most if not all transplant surgeons had been trained in Oxford and Cambridge.  The intention was now to create 4 transplant centres each doing 125 transplants a year.  In the event, there were finally 5 units based on the 5 enlarged Medical schools in the South-East – Imperial/Hammersmith/St Mary’s Paddington, University College/Royal Free, Queen Mary’s/Royal London, King’s College/Guy’s and St George’s University/Hospital.

Developments at St George’s

The chairman of St George’s Hospital Trust, Dr Elizabeth Vallance, and her board made the development of Renal Services a priority.  In April 1994, Dr Tony Wing’s Consultant Nephrology post was transferred from St Thomas’s Hospital to St George’s, and in August the first two dedicated Renal SHOs were appointed Crucially, in September, Mr René Chang was appointed as the first Renal transplant surgeon at St George’s, with Mr Mick Bewick from King’s College as his colleague.  At the same time, David Oliveira was appointed as Professor of Nephrology and Steve Nelson became the third renal physician.  The first cadaveric transplant took place in September 1994.

René Chang was keen from the start to make the kidney transplant results available to the patients, and did this by having an Annual public audit.  This was advertised to the St George’s patients, medical and nursing staff as well as members of St George’s management.  It ran in the same format from1994 until he retired in 2009 and continues till today howbeit in a different guise. He also took on a novel approach to immunosuppressant therapy making St George’s the first renal transplant unit to adopt tacrolimus (formerly known as FK506) as the calcinueurin inhibitor of choice.

Joyce Popoola, John Eastwood

De Gillian Matthew, Chair of the Joint Renal Services Planning Group, 1982

Last Updated on February 7, 2023 by neilturn