The Princess Alexandra Hospital is home to the only tertiary adult transplant unit in Queensland, and our haemodialysis unit is fortunate to be associated with this service. In the last 2 years we have experienced an increase of 130% in the number of plasma exchanges performed on patients in both the pre and post renal transplantation period. This treatment is clinically beneficial for patients with recurrence of focal segmental glomerulosclerosis (FSGS) and antibody mediated rejection such as positive B cell cross match and ABO incompatibility.

We were not prepared for the impact of provision of this service on staffing ratios, workload, staff education and budget, which have been influenced not only by the number of patients requiring this service but also by the conditions under which these transplants are performed.

This presentation will provide an overview of our experiences, including some case studies to highlight problems we encountered along the way. The objective of this presentation is to share our experience with other centres in the hope that they will be more prepared for these developments than we were.