Proposed Redistricting for Liver Transplant Sharing Negatively Impacts Georgia and Southeast

liver-250x250A proposed redistricting policy in the regional structure for liver transplant distribution may have a negative impact on the state of Georgia and the region.

Currently, the demand for liver transplants exceeds the supply of liver donations nationwide, and many patients with liver disease will die while on the waitlist to have this life-saving surgery. To decrease the disparity in wait times for liver transplantation in the U.S., the United Network for Organ Sharing (UNOS), with the support of the Scientific Registry of Transplant Recipients (SRTR), is proposing to change the current liver allocation distribution. This plan proposes to share donor organs more broadly in an attempt to reduce geographic disparities.

But experts at the Emory Transplant Center say the proposed changes would:

  • Drive up costs.
  • Decrease survival rates.
  • Lower the quality of donated organs because of a longer travel time to the intended recipient.
  • Extend the recovery period for the patient.
  • Exacerbate disparities in health care suffered by minority and rural communities.

The Southeast already faces substantial health-related disparities, including less insured patients, fewer available doctors and higher rates of liver disease overall.

The proposed redistricting will take organs from the South, which already has multiple barriers to liver disease care for minority, low-income, and rural patients, and send them to the Northeast, which has a much higher rate of listing liver disease patients.

Currently, the U.S. is divided into 11 regions. Georgia is in Region 3 along with Alabama, Arkansas, Florida, Louisiana, Mississippi and Puerto Rico. Within Region 3, livers are shared across state lines for patients with a MELD (Model of End Stage Liver Disease) score greater than or equal to 35. A MELD score is used to determine a patient’s place on the liver transplant waiting list. A higher MELD score means a higher mortality rate. Because some patients’ disease is poorly reflected by MELD alone, they may be granted an “exception score” to make them competitive for organs. Certain regions, however, grant these exceptions more freely, so that patients’ average scores at transplant may differ greatly between regions.

The new proposal would change the 11 regions to eight districts, with Georgia in District 1. The new district would expand up the Atlantic Coastline and include South Carolina, North Carolina, Virginia, Washington, DC, Maryland, Delaware, New Jersey, New York, Connecticut, Rhode Island, Massachusetts, New Hampshire, Maine, as well as Puerto Rico. Within this district, livers would be shared across state lines for patients with MELD scores equal to or greater than 29.

We feel the new proposal will have a negative impact on patients waiting for liver transplants in Georgia and across the Southeast. Emory prides itself on our commitment to our patients. In transplant, this commitment includes a dedication to maintaining availability of donor livers for patients most in need. For more information about liver transplants in Georgia and the Southeast and what you can do to help, visit the Collaboration for Donation Fairness website.

National Kidney Registry Awards Emory Transplant Center Coordinator for Quick Actions

Dr. Nicole Turgeon (left) and Sharon Matthews (right)

Dr. Nicole Turgeon (left) and Sharon Matthews (right)

The National Kidney Registry (NKR) has awarded Sharon Mathews, Lead Coordinator of Emory’s Living Donor Kidney Transplant Program, with its Grace Under Pressure Award. The NKR’s medical board voted for Mathews and a transplant coordinator from the University of Wisconsin – Madison, to receive the Grace Under Pressure Awards for their careful maneuvers and quick actions that led to a series of successful kidney transplants last summer. The NKR presents this award to an individual or organization that goes beyond what is expected and takes extraordinary measures to accelerate the practice of paired donor kidney exchange, resulting in the facilitation of more successful transplants.

The series of events began in July 2015 when a Good Samaritan donor started the chain in Madison, Wisconsin. The donor wanted to altruistically donate her kidney sometime in a five-day window so that she could recover in time for her college classes to start in the fall. The NKR identified a four-way swap that included a 14-year-old kidney transplant candidate at Children’s Healthcare of Atlanta. Doctors accepted the donor’s offer, Emory’s HLA lab completed physical crossmatching and the NKR finalized the swap logistics. All seemed ready to go.

A week before the scheduled surgeries, the paired donor in position 3 of the four-way swap decided against donating. The planned recipient of this kidney was an adult patient at Emory Transplant Center. So the centers quickly identified a “repair” option — the donor in position 2 could step in and donate a kidney to the position 3 candidate. Emory’s HLA lab performed a virtual crossmatch for the candidate. But then a few days before surgery, the candidate’s donor developed an elevated liver enzyme count and was ruled out. The centers identified a second repair option using virtual crossmatching and quickly solved this problem.

“Both of our centers [Emory and UW-Madison] worked hard to save the entire swap through the challenges that unfolded in the last several days before the scheduled transplant,” says Mathews.
Thanks to Mathews and her team’s hard work and the generosity of the altruistic donor in Madison, the swap began as planned, and the patient at Children’s received a living donor kidney. And at the end of the chain, the Emory waitlisted patient received a well-matched transplanted kidney as needed.

Mathews received the award on behalf of her team at the NKR’s Season of Miracles awards gala in New York City on May 4. “I dedicated my award to the entire Emory team that helped make these transplants successful, and I thanked my husband for his support,” says Mathews. “Living donor swaps/exchanges require tremendous coordination and expertise by our HLA lab, transplant surgeons, nephrologists, anesthesiologists, transplant clinic staff, bedside nurses, and O.R. staff. They all made it happen.”

Emory Transplant Center Awarded Grant to Reduce Disparities in Access to Transplant

two peopleThe National Institutes of Minority Health and Health Disparities has awarded $2.6 million over five years to the Emory Transplant Center and six other transplant centers and organizations in the Southeastern Kidney Transplant Coalition. The funding will continue the RaDIANT (Reducing Disparities in Access to Kidney Transplantation) Community Study in Georgia for another five years and expand it to South Carolina and North Carolina.

Emory Transplant Center epidemiologist Dr. Rachel Patzer, director of the transplant health services and outcomes program at Emory, is principal investigator of the grant and Dr. Stephen Pastan, medical director of the kidney and pancreas transplant program, is chair of the Southeastern Kidney Transplant Coalition and a study co-investigator.

“The grant will go a long way to help us expand some of the work we are doing in Georgia dialysis facilities and include North Carolina and South Carolina, with an emphasis on improving patient access to referral for a transplant evaluation,” says Dr. Patzer. “Our prior work showed that our interventions in the RaDIANT Community Study found that referral for transplantation nearly doubled and racial disparities were reduced. Now we will test whether we find similar effects in a larger, regional population.

Georgia and the Southeast have the highest rates of end-stage renal disease (ESRD) of any state or region in the U.S., but the lowest transplant rates. While the Emory Transplant Center has some of the best kidney transplant patient and graft survival rates of any center in the country, too few ESRD patients, especially those who have already started dialysis, are able to take advantage of these benefits. Research published by Dr. Patzer’s group last fall suggested that low rates of referral for transplantation may be the reason so few ESRD patients receive the benefits of kidney transplants. The Southeastern Kidney Transplant Coalition’s goal is to ensure equity in every step of the transplant process, including referral, medical evaluation, waitlisting, and transplantation.

The Emory Transplant Center is a partner in the Southeastern Kidney Transplant Coalition, an academic- and community-based collaboration that shares the common goal of eliminating health disparities that limit access to kidney transplantation among African American ESRD patients living in Georgia, North Carolina and South Carolina. The long-term goal of the coalition is to use community-based participatory research approaches to develop, test and disseminate interventions to improve transplant access.


about kidney transplant and the Emory Kidney Transplant Program

Giving the Gift of Life: Former Marine Donates Kidney to National Guardsman

MarineGuardsmanPhotoThe Emory Transplant Center loves to share heartwarming stories that happen right here in our Center. As we celebrate Donate Life month, we would like to honor those who have graciously made the decision to give the gift life. Former Marine, Temple Jeffords, is one of those individuals. He made the decision to donate one of his kidneys to help out a fellow serviceman.

It all started with a plea for help via social media. Suffering with Stage 4 kidney disease, 28-year-old Dustin Brown, Army National Guardsman, relied on dialysis machines to rid his body of waste, salt and water that his failing kidneys could no longer do. Doctors told him a kidney transplant was needed.

Dustin connected with Kristi and Raleigh Callaway. Raleigh Callaway, a Greensboro, Georgia, police officer, received a new kidney in 2014 following a Facebook post publicly appealing for help.

Soon Brown, posing with his wife and five-year-old son, had a similar Facebook post on the Callaway’s page, desperately searching for a new kidney.

Former Marine, Temple Jeffords, saw the plea for help and contacted Kristi Callaway and the Emory Kidney Transplant Program. A few weeks later, 44-year-old Jeffords learned he was a match for Brown.

“I have never thought about donating a kidney to anyone, but when I saw another serviceman’s need for help, I wanted to help,” says Jeffords. “The testing and donating processes are simple.”

Living donor kidney transplants, such as this one, make the wait times shorter for critically-ill patients, while also providing the greatest chances for long-term success,” says Nicole Turgeon, MD, surgical director of the Paired Donor Kidney Exchange Program at Emory Transplant Center.

“I am so thankful for Temple,” said Brown, just days after his kidney transplant surgery. “Brothers in arms are always brothers, no matter what. He is a super hero in our family.”

Watch the story featured on ABC News here.

Watch the story featured on Fox News here.

about kidney transplant and the Emory Living Donor Kidney Program 

Emory Transplant Center Receives Special Visit from Former NFL Player and Kidney Transplant Recipient

transplantThe Emory Transplant Center received a special visit from former NFL player Donald Jones, who received his own kidney transplant in 2013 following kidney disease. On Wednesday, March 16th, Jones visited with faculty and staff at Emory Transplant Canter and then went on to meet with kidney transplant patients at Emory University Hospital. It was quite a delight for our patients.

Jones was a wide receiver for the Buffalo Bills from 2010 to 2012. While playing with the Bills, he began developing high blood pressure and experienced some vision loss. Then the New England Patriots signed him in 2013. But only a few months later, he was diagnosed with IgA nephropathy, a kidney disorder that occurs when IgA, a protein that helps the body fight infections, settles in the kidneys. Treatment for the disorder is dialysis or a kidney transplant.

Jones retired from the NFL in August 2013 at just 25 years old. In December 2013, Jones received a life-saving kidney transplant from his father. Since then, he has been traveling the country raising awareness and fundraising for kidney disease and IgA nephropathy.

Emory Transplant Center faculty and staff had the opportunity to attend a book signing of Jones’ recently published autobiography, The Next Quarter: Scoring Against Kidney Disease. And Emory kidney transplant recipients Robert Burns and Angela Parks, both from Decatur, were delighted to have Jones drop by their Emory University Hospital rooms.

While at Emory, Jones was also interviewed for an educational video about dialysis and kidney transplantation. Rachel Patzer, PhD, MPH, assistant professor of surgery in Emory University School of Medicine and Rollins School of Public Health, recently received funding to develop a video following her research study about kidney transplant rates, published in the Journal of the American Medical Association in August 2015.

The study found only about one in four patients with end-stage renal disease in Georgia was referred by a dialysis facility to a transplant center for evaluation within one year of starting dialysis. Patzer hopes the video will educate dialysis patients about transplant as a treatment option and encourage patients to discuss transplant with their providers and family members.

The video, once released, will be distributed to dialysis centers throughout the U.S. that have low rates of transplant or racial disparities in access to transplant.

about kidney transplant and the Emory Kidney Transplant Program

Emory Transplant Center Ranks 7th Nationally

The Emory Transplant Center ranks 7th among transplant programs across the nation based on adult transplant volumes. In calendar year 2014, we performed 441 adult transplants that placed us 7th overall, tied with Barnes-Jewish Hospital. Our top 10 ranking puts us among good company.






And with the recent release of the latest Scientific Registry of Transplant Recipients (SRTR) data, it revealed that all Emory solid organ programs, when risk-adjusted, are similar to if not statistically different from the national data and meet expectations for performance set by the United Network for Organ Sharing (UNOS) Membership Professional Standards Committee (MPSC).

The new SRTR center-specific data included the following one-year graft and patient survival rates for our patients:

Patient survival rate: 90.4% (actual) vs. 90.75% (expected)
Graft survival rate: 80.95% (actual) vs. 84.3% (expected)

Patient survival: 98.1% (actual) vs. 97.4% (expected)
Graft survival: 95% (actual) vs. 94.4% (expected)

Patient survival: 100% (actual) vs. 97.9% (expected)
Graft survival: 100% (actual) vs. 95.8% (expected)

Patient survival: 93.8% (actual) vs. 91.6% (expected)
Graft survival: 91.7% (actual) vs. 89.2% (expected)

Patient survival: 84.7% (actual) vs. 87.1% (expected)
Graft survival: 84.5% (actual) vs. 90% (expected)

*adults; cohort 1/1/12 – 6/30/14 (deaths and re-transplants were counted as graft failures)

Also of note, the Emory Kidney Transplant program’s three-year graft survival remains statistically greater than expected (p < 0.05) with outcomes of 89.48% (actual) vs. 86.29% (expected).

Our experience coupled with continued excellent outcomes in all solid organ programs make the Emory Transplant Center a leading transplant destination in the Southeast and the nation, serving patients in Georgia and bordering states. We are proud to be your transplant center.

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 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.”

Emory Liver Transplant Program Raises the Bar

transplant quality measuresAccording to the December 2014 Scientific Registry of Transplant Recipients (SRTR) report, Emory’s adult and pediatric liver transplant program is the second busiest in the nation, establishing the Emory Liver Transplant Program as a leader across the U.S. This feat is made more remarkable by the fact that while volume in the adult program has more than doubled over the past six years, survival outcomes have also dramatically improved, according to the SRTR data.

The Scientific Registry of Transplant Recipients (SRTR) is a national database of transplant statistics. The registry evaluates both the scientific and clinical status of solid organ transplantation for all programs across the nation. This includes the number of transplants performed, wait-list candidates, transplant recipients, and survival statistics for each program.

The liver teams at the Emory Transplant Center and Children’s Healthcare of Atlanta performed 145 adult and 18 pediatric liver transplants (one of which was from a living donor) in calendar year 2014. This is up from a total of 91 adult and pediatric transplants in 2008.

In the most recent SRTR report, Emory’s one-year adult patient and graft survival rates were 92.8% and 89.8%, respectively, both rates were higher than expected. We credit this to the team of talented and committed individuals who work hard work each and every day.

“We have come a long way over the years in the adult program, increasing volume while still improving outcomes,” says Dr. James Spivey, medical director of the program. “Much of the credit goes to a restructuring of our clinical teams to improve outcomes and increase quality of care, productivity of our teams and efficiency in the transplant process for patients. For example, we were able to increase waitlist additions. Through the generous gift of organ donation, this has helped result in increased transplant rates in recent years.”

Changes to the UNOS Kidney Allocation System

Organ Donation Wait TimeThe Emory Transplant Center would like to share with our transplant community some important changes to the kidney allocation system managed by the United Network for Organ Sharing (UNOS). As many of you know, UNOS manages the nation’s organ transplant system and helps make the best use of donated organs. More specifically, the UNOS Kidney Committee had been meeting regularly to discuss an improved kidney allocation system which resulted in the UNOS Board of Directors approving a new kidney matching system that took effect on December 4, 2014.

Under the previous system, how long a person had undergone dialysis prior to being placed on the wait list did not count. But with this new system, it has changed.

“One of the major differences is that now you will be given credit for your dialysis time that will be added on to the time you’ve been on the waiting list,” says kidney transplant surgeon Dr. Nicole Turgeon of the Emory Kidney Transplant Program.

If you began dialysis before you were listed, your wait time will be backdated to the day you began dialysis. Dr. Turgeon says the new guidelines could really help many longtime dialysis patients.

Here are some important points to note with the new system:

  1. The time you spend waiting for a kidney is still a major factor in organ matching.
  2. You will not lose credit for any time you have already spent waiting.
  3. If you began dialysis or met the medical definition of kidney failure at the time you were listed for transplant, your waiting time will not change.
  4. If you began dialysis before you were listed for a kidney transplant, the time between beginning dialysis and being listed will be added to your waiting time.
  5. People who have the longest potential need for a transplanted organ and those who have been difficult to match under the current system will receive greater priority under the new system.
  6. The new system should provide more transplant opportunities, so that everyone has a better chance to be transplanted.

“It is big news for our patients. I think it’s really going to help them in terms of getting better access to transplants,” says Dr. Turgeon.

UNOS continues to monitor the system closely to make sure it is meeting the needs of patients. For more detailed information about the new kidney allocation system, visit the UNOS website at