Site Visits Show Emory Transplant Center’s Patients are in Excellent Hands

GoldSeal_4colorSuccess in a transplant center is measured by many standards — high patient and graft survival rates, satisfied patients and quality care, to name a few — but Emory really does stand out
when national regulatory agencies come for required site visits. Three agencies, the United Network for Organ Sharing (UNOS), the Joint Commission (TJC) and the Centers of Medicare & Medicaid Services (CMS), visited the Emory Transplant Center (ETC) this year. Their hard work was evident in the positive comments we received from the surveyors.

For the first time in ETC’s history, the Joint Commission surveyed hospital-based outpatient clinics during their site visit in July – this included both the ETC’s Outpatient Transplant Clinics at Emory Saint Joseph’s Hospital and the Emory Clinic.

“The surveyor was happy with the nurses’ notes on a sample procedure stating, ‘This is the only chart I have ever read that has all the information I was looking for when a patient is being discharged from the clinic after a procedure.’ She was impressed.”, reports Joji Taganajan, nurse manager.

Our CMS re-certification survey was conducted the last week of April. The reviewers surveyed Emory’s heart, kidney, liver, lung, and pancreas programs, examining medical records for documentation of the multiple CMS conditions of participation, reviewing ETC policies, practices, and quality assessment and performance improvement (QAPI) programs. All five transplant programs were re-certified.

Additional good news came to the programs on July 13 in the form of letters from the UNOS Membership and Professional Standards Committee (MPSC). The MPSC reported results of its routine on-site review of the programs, conducted by the UNOS staff the week of January 26. The purpose of the survey, which is conducted every three years, is to review and analyze transplant program compliance with UNOS/OPTN (Organ Procurement and Transplant Network) policies. All ETC programs passed with scores between 92 and 100.

A heartfelt thank you goes out to all our transplant staff, faculty and leadership who provide our patients and families excellent clinical care on a daily basis, while achieving impressive quality outcomes and meeting the multiple federal regulatory requirements for transplant centers.

Emory Liver Transplant Program Appoints New Surgical and Medical Directors

Dr. Ram Subramanian

Dr. Ram Subramanian

Dr. Joseph Magliocca

Dr. Joseph Magliocca

There have been some exciting changes happening at the Emory Transplant Center – specifically within the Emory Liver Transplant Program. Just a little over six months ago, Dr. Joseph (Joe) Magliocca was appointed Surgical Director of the Liver Transplant Program. Dr. Magliocca joined Emory four years ago from Shands Hospital at the University of Florida. His research interests include liver preservation and perfusion with a goal of increasing the number of livers available for transplantation. He serves as an associate editor of the American Journal of Transplantation, the world’s most widely read peer-reviewed publication for transplant professionals. In addition, the American Society of Transplant Surgeons (ASTS) recently appointed him to serve on the PROACTOR Task Force (PROviding better ACcess To ORgans) to investigate ways to increase access to transplantation.

Meanwhile, Dr. James Spivey has stepped down as Medical Director of the Liver Transplant Program to serve as vice chair for clinical affairs in the department of medicine. Dr. Spivey will continue work as a transplant hepatologist, and provide both administrative guidance and clinical expertise at the Emory Transplant Center. In his new role, Dr. Spivey will work closely with chair Dr. David Stephens, Emory Medicine’s senior departmental administrative leadership and the division directors on strategic initiatives and will manage clinical faculty issues.

As a result of Dr. Spivey’s new role, we are proud to announce that Dr. Ram Subramanian has been appointed new Medical Director of the Liver Transplant Program. He has a dual role as both a transplant hepatologist and an intensivist. He began his career at Emory in 2007 and currently is the physician liaison for the abdominal transplant midlevel provider group. His clinical interests include inpatient care before and after liver transplantation, and his research is focused on critical care issues related to hepatic failure and liver transplantation.

While we have come a long way over the past decade, the Emory Liver Transplant Program continues to take steps to improve outcomes for patients, increase the donor pool, develop better surgical and medical techniques that improve quality of life, and create policies and procedures that increase productivity and efficiency in our program. We look forward to guidance under our new leadership.

Emory Transplant Center Celebrates National Minority Donor Awareness Week

multi-ethnicAugust is a good time to honor our minority donors who make the benefits of transplantation possible. National Minority Donor Awareness Week, celebrated annually on August 1-7, is a nationwide observance to honor the generosity of multicultural donors and their families, while also underscoring the critical need for people from diverse communities to become organ donors.

The Emory Transplant Center is committed to bringing attention to the critical need for organ donors. The need for minority donors is especially profound.

2014 Statistics:

  • 58% of individuals on the national organ transplant waiting list were comprised of minorities (this number includes Blacks, Asians, Hispanics, American Indians, Pacific Islanders and people of multiracial decent)
  • 32%
of all deceased donors were minorities
  • 42%
of all those receiving transplants were minorities
    (Source: U.S. Department of Health & Human Services)

We would like to honor minorities who have been donors, and encourage others to register as donors. A greater diversity of donors may potentially increase access to transplantation for everyone. For more information, please visit and “Why Minority Donors Are Needed.”

Improving Dialysis Patients’ Lives Through Kidney Transplantation

Emory Transplant Center continues to be a leader in research by studying ways we can better bring the benefits of kidney transplantation to Georgia residents. Several Emory studies have documented that receiving a kidney transplant before dialysis, or soon after beginning treatment, can improve patient outcomes and quality of life.

A recent study conducted by the Emory Transplant Center, along with two other healthcare systems in Georgia and the Southeastern Kidney Transplant Coalition, looked at why patient referral rates from dialysis centers to transplant facilities were so low. They found that three-quarters of Georgia patients on dialysis were not even being evaluated for a possible kidney transplant within their first year of dialysis.

“The study found that fewer than 28% of Georgia dialysis patients were referred to one of the state’s three adult kidney transplant centers within a year of starting dialysis,” reports Dr. Stephen Pastan, Medical Director, Emory Kidney Transplant Program, reports.

Georgia has the lowest kidney transplant rate in the country. U.S. regulations require that all dialysis centers in Georgia inform patients of kidney transplantation as a treatment option within 60 days of starting dialysis. Yet the study identified 15 Georgia dialysis facilities that referred zero patients within one year of dialysis start. The dialysis facilities with the lowest transplant referral rates were more likely to be non-profit, have more patients, and a higher patient-to-social worker ratio. Kidney transplantation is a typically less expensive intervention than ongoing dialysis and one that also promises greater longevity and a better quality of life.

One of the first key steps for many patients to receive kidney transplantation is to hear about its life-changing benefits at a dialysis center. This study illustrates the need for further measures to improve overall referral of patients to kidney transplantation.

Learn more about the Emory Kidney Transplant Program or call us at 1-855-EMORYTX (366-7989)

Flu Vaccination Proves to Reduce Rejection in Transplant Recipients

transplant_7-30-200x300Although we are currently in the throws of summer heat, schools will be starting back in the next few weeks and soon the Fall season will be upon us. With that begins flu season. The Emory Transplant Center has always encouraged our patients to get their flu shot early on in the season, and now a research study has proven it to be most effective in reducing rejection. A recent Emory study presented at the Emory Transplant Center shows that a flu shot in the first year post-transplant reduces rates of hospitalization for recipients of all organ types. The study also proved that vaccination reduces acute rejection rates among transplant recipients.

“We designed our study to compare the clinical outcomes between solid organ transplant recipients [lung, heart, kidney, and liver] at Emory University Hospital who receive flu vaccination with those who didn’t,” says Dr. G. Marshall Lyon III, Associate Professor of Medicine and Director of Transplant Infectious Diseases.

The investigators reviewed the charts of 586 recipients who received transplants from January 1, 2011 to September 1, 2012. They studied a cohort of patients who received flu vaccines during the first full flu season after their transplants and compared it to a cohort of non-vaccinated patients. The researchers collected the outcomes from each recipient for one year beginning with the start of the first full flu season – September 1st – after their transplants.

The study showed the recipients had an overall vaccination rate of 59.3%. The rate of hospitalization per patient year was lower in the vaccinated group, with 0.34 admissions per patient year for the vaccinated group and 0.51 admissions per patient year in the non-vaccinated group. When rejection episodes that were diagnosed on the date of vaccination were removed from the vaccinated group and attributed to the non-vaccinated group, there was a significant reduction in the rate per patient year, with a rejection rate of 0.13 for vaccinated patients and 0.22 non-vaccinated patients.

Learn more about the Emory Transplant Center.

Finding a Better Antifungal Agent for Lung Transplant Patients

Transplant_7-16Because human airways are open to airborne fungal spores and pathogens, lung transplant patients are especially susceptible to infections, a major cause of post-transplant disease and even death. A reliable means of preventing fungal infection in lung transplant patients is the drug posaconazole. Even though it serves well for preventing infection, the oral suspension has poor bioavailability, or absorption into the bloodstream, and patients need to have low gastric pH and high dietary fat intake for adequate systemic exposure.

In November 2013, the FDA approved a new formulation, a posaconazole extended-release tablet, which doctors at Emory Transplant Center began prescribing to patients because of its predictable absorption and improved systemic exposure.

“The purpose of the research study was to compare the oral suspension with the extended-release tablets and determine the likelihood of achieving therapeutic posaconazole levels, which provides the optimal benefit for patients,” says Michael Hurtik, clinical pharmacist for the heart and lung transplant programs, who was the first author on the study. He and the team’s pulmonologists, including Emory Lung Transplant Program medical director, Dr. David Neujahr, looked at data from a cohort of Emory Transplant Center patients who received single or bilateral lung transplantation between January 2013 and October 2014, and were treated for four months post-transplant with nebulized amphotericin and posaconazole oral suspension or the extended-release tablets.

The results showed that the use of the new posaconazole extended-release tablets resulted in therapeutic blood levels for fungal prophylaxis more often (87% of patients) than the oral suspension formulation (39%). The lung transplant patients studied also tolerated the tablets well and no one needed a dose reduction or discontinuation of the medication. This study was successful in finding a better antifungal agent for our lung transplant patients that also provides the most optimal health benefit.

Learn more about the Emory Transplant Center.

Celebrating Emory Transplant Center’s Social Workers

transplant-social-worker-supportIn March, we celebrated Emory Transplant Center social workers as we commemorated National Social Work Month. Information fairs were held to educate patients and their families about the role social workers play in the transplant process, and resources that can help our special patient population. The theme for the month was “Social Work Paves the Way for Change,” which was a good way to describe exactly what our 16 transplant social workers do every day.

ETC social workers help make positive changes in individual patients throughout the transplant process as well as for the transplant community as a whole. They assess and address the emotional, psychosocial, adjustment, and resource needs of patients and caregivers throughout the transplant journey. Social workers serve as a voice to speak up for the best interests of transplant patients and their families. They evaluate available social support and provide education to patients and families. Social workers are instrumental in linking patients with community resources to meet their financial, medication access, insurance, legal, and/or mental health needs. In addition, they are available to provide supportive counseling to transplant recipients and family members.

All Emory Transplant Center social workers have master-level degrees and many have specialized training and certifications that meet specific educational, licensing and experience requirements from national professional organizations. Our social workers are an essential part of the transplant team and every patient’s transplant process. Please join us in thanking our transplant social workers for the work they do every day.

Takeaways from Dr. Turgeon’s Organ Donation and Paired Donor Exchange Live Chat

organ donation monthThank you to everyone who joined us during National Donate Life Month for the live web chat hosted by Emory Transplant Center surgeon, Dr. Nicole Turgeon. Dr. Turgeon answered questions about organ donation, including paired donor exchange – what it is, how it works and how paired donor exchange is helping patients get a second chance at life.

Perhaps the most important message from Dr. Turgeon was one on the importance of organ donation and how it can have a huge impact on people’s lives.

We were thrilled with the number of people who registered and were able to participate in the chat. The response was so great that we had a few questions we were not able to answer so we have answered them below for your reference.

If you missed this informative chat, be sure to check out the full list of questions and answers located on our chat transcript. You may also visit the Emory Transplant Center website for more information. And for more information on how to become an organ donor, visit

Question: My grandmother is on dialysis and she is 73. Can she be placed on the waitlist for transplant? 

turgeon-nicoleDr. Turgeon: Before anyone can be placed on the wait list for organ transplantation, he/she will need to be evaluated by a transplant physician to determine if he/she meets medical criteria for transplant, e.g. is the patient healthy and strong enough for transplant. There are also criteria around patient support care as well as financial requirements. We are happy to evaluate your grandmother. To schedule an appointment for evaluation, call 1-855-EMORYTX (366-7989). It is a toll free number.

Question: Will kidney donation affect pregnancy?

turgeon-nicoleDr. Turgeon: Women who donate a kidney can become pregnant after donation and deliver healthy babies. But we do recommend waiting 1 year after donation to become pregnant in order to heal from surgery and for your kidney function to be stable.



Question: What is the kidney donor waiting list exchange?

turgeon-nicoleDr. Turgeon: If a paired exchange cannot be found, living donors in certain areas of the country may be eligible for living kidney donor list exchange. In this type of exchange, a kidney donor who is not compatible with their intended recipient offers to donate to a stranger on the waiting list. In return, the intended recipient advances on the waiting list for a deceased donor kidney. This type of living donation is also referred to living donor/deceased exchange.


If you missed this informative chat with Dr. Turgeon, be sure to check out the full list of questions and answers on the chat transcript.

If you have any questions for the doctor, do not hesitate to leave a comment in our comments area below.



Eat Well, Live Well: The Importance of Nutrition for the Transplant Patient

transplant nutritionWe all know good nutrition plays a critical role in overall health. But for transplant patients, good nutrition is especially important. Francoise Maillet, a clinical dietitician who works with the Emory Transplant Center, wrote an informative article that highlights the importance of nutrition and the powerful impact it has on the wellbeing of a transplant patient’s life.

“In the waiting period prior to a transplant, good nutrition plays a vital role in helping the potential recipient maintain maximum health and wellbeing. This can greatly affect the transplant surgery itself, the healing process, and also the quality of life afterward”, Maillet writes in her article, Eat Well to Live Long.

She continues on to say that post-transplant, the need for calories, protein, vitamins and minerals is increased during recovery. If nutritional needs are not met, malnutrition occurs. Malnutrition is when the body is significantly deprived of adequate nutrition. When the body is malnourished, there is a decrease in muscle mass and protein stores, leading to an impaired immune response (meaning the body will have difficulty fighting infection). Malnutrition can also interfere with the body’s ability to heal a wound; resulting in a lack of the building blocks needed to build and repair tissue.

A balanced, healthy diet will promote recovery and wellness. Prior to transplant, it is important to meet with a clinical nutritionist who can evaluate your diet and teach you the right foods to eat in order to meet your individual needs before and after transplant. Making healthy food choices is essential for your best outcome.
To read more, download the full article by clicking here.

Understanding Organ Donation: Deciding to Give the Gift of Life

organ donation monthApril serves as National Donate Life month – raising awareness around organ donation and celebrating those who have given the precious gift of life to another. Currently more than 115,000 men, women and children are awaiting a life saving transplant. They are in need of organs, tissue, and bone marrow which can all be transplanted if donors were available, giving recipients a second chance at life. Understandably, potential donors may have reservations about organ donation. The Emory Transplant Center has compiled a list of pros and cons to help you with your decision to become an organ donor. Of note, the cons referenced below may in fact not be cons at all, but rather based on misconceptions.


  • ONE organ donor can save up to EIGHT lives. With more than 115,000 men, women and children awaiting organ transplant in the U.S., by registering to become an organ donor you can help save lives.
  • For the transplant recipient, it is a second chance at life. For some, an organ transplant means no longer having to be dependent on costly routine treatments to survive. It allows many recipients to return to a normal lifestyle.
  • For the family of the deceased donor, they feel a sense of goodness that came from a tragedy – that if the organs are transplanted into a young, deserving person, then their loss was not in vain. Donor families take some consolation in knowing that some part of their loved one continues in life.
  • Living Donation – It is possible to donate organs while you are still alive. One can donate a kidney, portions of the liver, lung, pancreas and intestines, as well as bone marrow, and go on to live healthy lives. Most often it is a relative or a close friend who donates, but there are others who choose to donate to a complete stranger.

Cons (Misconceptions):

  • Families might be confused by the fact that donor bodies are often kept on life support while the tissues are removed. Surgeons do not remove any tissues unless the person is brain dead, but they sometimes put the body on a ventilator to keep the heart pumping fresh blood into the tissues to keep them alive long enough to harvest. This is not the same as life, but there is a moment when the ventilator is removed and the heart stops.
  • Many individuals incorrectly believe that if they donate organs that they or their family will then need to fund the cost of the operation used to remove the organ. This is not the case as costs actually fall to the recipient.
  • Another “con” might be that the donor does not usually get to choose who the organs go to, and perhaps an organ will go to someone of a different faith, political viewpoint or temperament than the donor. The donor has to believe that all life is sacred and that anyone who receives the “ultimate gift” of a donor organ will be grateful and be imbued with a sense of gratitude and a desire to pay it forward.

To learn more about organ donation, join Dr. Nicole Turgeon of the Emory Transplant Center for a live chat on Tuesday, April 28th from Noon – 1PM. She will answer all of your questions about organ donation, including how many people are currently waiting for an organ, what organs can be donated, and who can donate. She will also discuss paired donor exchange – what it is, how it works and how paired donor exchange is helping patients get a second chance at life. Register for the chat here.
To become a donor and for more information visit Donate Life of Georgia.