Transplant First

Transplant First

Transplant First aims to increase the number of pre-emptive transplants (transplants before someone needs to start renal replacement therapy) in the UK.

Transplant First started as a project in the West Midlands where we recognised that we had very low rates of pre-emptive transplant listing. The project led to improved rates of pre-emptive listing but also a change in culture around the regional renal teams in promoting quality improvement.

Clinical project lead, Transplant First

Why Transplant First?

It is well recognised that for patients with advanced kidney disease, a transplant is the best form of renal replacement therapy.

Patients themselves often want to have a transplant as soon as possible to avoid dialysis. Not every patient will be suitable, but if they are, receiving a transplant either before starting dialysis (pre-emptive) or shortly after has been shown to be beneficial.

For patients who have access to living kidney donor transplant (LKDT) there is even more benefit. Despite this, there is huge variability in access to the transplant waiting list. The UK Renal Registry and NHSBT reports show that across the UK, different kidney and transplant units have widely differing rates of pre-emptive transplant listing, time taken to listing, and access to LKDT. For a treatment which is so beneficial to patients and cost-saving, this cannot be acceptable.

Importantly Transplant First is not about:

  • Transplanting people earlier than is good for them

  • Changing listing criteria

  • Favouring the care of pre-emptive patients over those on dialysis

Whether you choose to do Transplant First as a regional improvement network or do a small quality improvement project in your own unit, thank you for working to improve access to the best care possible on behalf of people living with kidney disease and their donors.


Read about the history of Transplant First 

Read the latest Transplant First newsletter here

Transplant First is on Twitter – follow us @Transplant1stUK


Are you are interested in getting involved?

Contact us at


NICE accredited clinical practice guidelines 

Available here

23rd Annual Report

Analyses about the care provided to patients at UK renal centres.

Read the report


A report on the nationwide collection of AKI warning test scores. 

Read the report