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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 www.unos.org.

AJC Features Emory Transplant Center Patients Freed of Type 1 Diabetes

islet transplant patientThe Emory Transplant Center is one of just a handful of institutions around the world performing islet transplants as a type 1 diabetes treatment. Emory is currently the only islet cell transplant program in Georgia, with 19 patients receiving islet transplants to date.

Islet cell transplant is still in the research phase awaiting Food and Drug Administration (FDA) approval so the surgery will no longer be experimental. Read a story in the Atlanta Journal Constitution featuring two Emory patients who have been diabetes free for a decade now thanks to islet transplant at Emory.

Learn About Islet Transplants

What Are Islets?
Islets are insulin-producing cell clusters found in the pancreas, which is a six- to ten-inch organ that lies behind the stomach. Each islet cluster is about the size of a grain of salt and contains a few thousand cells. A healthy pancreas has approximately a million islet clusters.
Glucose is the fuel that provides energy to cells. Insulin allows glucose from the bloodstream to enter cells. Without insulin, cells are deprived of fuel, and they begin to starve. As the cells starve, the level of glucose in the bloodstream rises to dangerous levels.
In type 1 diabetes, islets in the pancreas are destroyed by the body’s immune system. Without islets, the body cannot produce insulin. People with type 1 diabetes require several injections of insulin each day. They must follow a strict diet and monitor their blood glucose carefully. Sometimes, even the most diligent patients cannot completely control their blood sugar levels. Diabetes that is very difficult to control is called brittle diabetes.

Why Islet Transplantation?
Islet transplantation can restore insulin production by replacing the islets that have been destroyed. When insulin production is restored, blood glucose levels stabilize, and the health risks associated with low and high blood sugars are greatly reduced.

What Is an Islet Transplant?
The islet cell transplant process begins when islets for transplantation from a donated pancreas become available. During the islet transplantation procedure, the islets are infused into a blood vessel that leads to the liver. The islets from the pancreas are also separated from other cells through a highly complex process called “islet isolation.” The islets are then infused and lodged into the liver of the recipient, where they are able to detect the level of glucose in the blood and produce the correct amount of insulin. Recent advances in islet isolation have resulted in sustained insulin independence in people with type 1 diabetes, which may make islet transplantation more common in the foreseeable future.

Emory University Hospital Midtown Honors Organ Donors

Emory Hospital Donate LifeEarlier this month, team members from Emory University Hospital Midtown gathered on the steps of the hospital to recognize and celebrate organ donors.

Currently, there are more than 120,000 men, women and children in the United States who are waiting on an organ transplant. Though transplantation saves thousands of lives each year, there are always many more people in need of a transplant than there are organ donors. With that in mind, a team of nurses, chaplains and staff have boosted efforts to raise awareness of organ donation.

“Organ donation is a difficult thing to talk to families about, especially when they’re facing the sadness of losing a loved one,” explained Sheila Taylor, RN, an intensive care nurse and the nurse champion for organ donation awareness at Emory University Hospital Midtown. “It is so important to share with people just how many lives organ donation can save.”

100,000 People are Waiting for a Kidney. Learn More About Emory’s Paired Donor Exchange Program

Paired Donor Exchange ProgramDid you know that there are nearly 100,000 people on the kidney transplant waiting list? With the average wait time for a kidney now at four years, patients are often eager to seek other options to waiting on a deceased donor kidney so that they can get back to living a healthy life. Fortunately, with today’s medical advances, a living or a deceased person can donate a kidney.

The Emory Transplant Center launched its Kidney Paired Donor Exchange Program in 2010 and has been participating in the National Kidney Registry since 2012. Join Nicole Turgeon, MD, associate professor of surgery, Emory University School of Medicine and surgical director of the Paired Donor Exchange Program on April 8 for an online live chat to learn how paired donor exchange works, what it takes to become a donor and how paired donor exchange is helping patients dramatically improve their quality of life.

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10 Years and Still Diabetes Free – Islet Cell Transplant Patients Celebrate Anniversary of Life-Changing Procedure

islet-trans-patients“I feel free. I feel normal.” That’s what Emory Transplant Center patient Laura Cochran says of her life since having a pancreatic islet cell transplant to treat her brittle Type 1 diabetes.

Last week, Cochran, along with the Emory Transplant Center team and fellow patient Rob Allen, gathered to celebrate the 10-year anniversary of their participation in a clinical trial for their severe Type 1 diabetes. Type 1 diabetes is an autoimmune disease in which the pancreas ceases to produce insulin, a hormone that allows people to get energy from food. Type 1 diabetics must take insulin every day to live.

Both Cochran and Allen were diagnosed with Type 1 diabetes as young adults. Allen’s diabetes was controlled with insulin injections for about 10 years until his episodes of low blood sugar became more frequent and more severe. As for Cochran, as her diabetes progressed, she developed hypoglycemia unawareness, where her blood sugar would drop so low so quickly, that she didn’t recognize how low her sugars were. She often became dazed during these episodes and had to be watched at all times. While both benefitted some from insulin pumps, they still needed more relief. Fortunately, they were candidates for a clinical trial at Emory where donor pancreatic islet cells were transplanted to restore insulin production in people with Type 1 diabetes.

Cochran and Allen each received two islet cell transplants from two different organ donors, several months apart. After the first transplant, they both still needed small amounts of insulin injections. After the second transplant, neither Cochran nor Allen needed insulin injections. Both have been insulin free since 2004.

“We transplanted just two teaspoons of islet cells into these patients 10 years ago, and they no longer need insulin injections,” says Christian Larsen, MD, DPhil, professor of surgery in the Division of Transplantation at Emory, and dean of Emory University School of Medicine. “This has been a miraculous transformation.”

Researchers are awaiting FDA approval of islet cell transplants so that the surgery will no longer be experimental. Once approval is obtained, surgeons can perform these transplants on patients who meet the criteria.

“The best part about the islet cell transplants is not having to worry daily about my blood glucose levels getting out of control,” says Allen. “It has been an amazing thing.”

Related Resources

Emory Islet Transplant Program
Islet Transplant For Type 1 Diabetes? Julie Allred’s Story

Emory Transplant Center Executive Director Elected to National Council by Peers

Dr. Thomas C. Pearson

Dr. Thomas C. Pearson

Thomas Pearson, MD, DPhil, executive director of the Emory Transplant Center, has been elected by organ donation professionals as incoming associate councillor of the Organ Procurement and Transplant Network and United Network for Organ Sharing (OPTN/UNOS) Region 3. Each of the 11 OPTN/UNOS regions has an associate councillor who serves as the regional representative to its national Membership and Professional Standards Committee. This committee oversees transplant community membership, policy and regulatory compliance and makes recommendations to the board regarding policy violations.

“Since 1991, Tom has been a valued friend and colleague at Emory and an esteemed transplant surgeon, bench and clinical researcher,” says Christian Larsen, MD, DPhil, dean of Emory University School of Medicine, former executive director of the Emory Transplant Center and a current kidney transplant surgeon. “But he also is internationally respected as a transplant immunologist, educator and transplant advocate, establishing many protocols in place today. He is perfectly suited to this role at OPTN/UNOS Region 3.”

Pearson, who is surgical director of the kidney transplant program at Emory and the Livingston Professor of Surgery, joined the Emory faculty in 1991. Together, with long time collaborator Larsen, they played a pivotal role in developing a new class of immunosuppressive drugs to replace the cyclosporine class of drugs and their major side effects and toxicities. The FDA approved the co-stimulation blocker called belatacept in June 2011 for kidney transplant recipients. This was the first time a new class of drug had been approved for transplant since the 1990s.

After Pearson’s term as associate councillor ends in 2016, he will assume the role of councillor for an additional two-year term of service (2016-2018), representing Region 3 on the OPTN/UNOS board of directors. Pearson also serves as medical director of LifeLink of Georgia, is a member of the Board of Governors for the LifeLink Foundation and is a board member of the American Society of Transplantation.

Mother Daughter Team Kicks Off Six-Way Kidney Swap

kidney-swapWhen Mother’s Day rolls around this year, Cindy Skrine and her daughter, also named Cindy, will have a lot to celebrate. Having lived with kidney disease for many years, the elder Cindy needed a kidney transplant. Her daughter was tested as a donor, but ultimately was not a match for her mother. She was, however, a match for someone in California. With the help of Emory’s Kidney Paired Donor Exchange program, thus began a six-way kidney swap that stretched from Georgia to California to Tennessee and then back to Georgia.

“Emory began its Kidney Paired Donor Exchange Program in 2010, and we have been participating in the National Kidney Registry since 2012,” says Nicole Turgeon, MD, associate professor of surgery, Emory University School of Medicine and surgical director of the Paired Donor Exchange Program. “Paired donor exchange gives patients an opportunity to receive a living donor kidney transplant from a loved one or friend, despite incompatible blood types and positive crossmatches. In paired donation, a donor and recipient are matched with another incompatible donor and recipient pair, and the kidneys are exchanged between the pairs.

According to Dr. Turgeon, there are currently more than 100,000 people on the kidney transplant waiting list. The discrepancy between the number of organs available and the number of people on the waiting list continues to grow. The Emory Transplant Center is the state’s largest transplant center performing the highest volume of kidney transplants in Georgia.

To learn more about the Skrine’s story, check out the video below:

Visit the Emory Kidney Transplant Program website for more information on the Emory Paired Donor Exchange program.

Celebrating the Gift of Life in the New Year

Donate Life New Year's FloatWhile many people were recovering from New Year’s Eve parties and setting their resolutions for 2014, Emory transplant recipients Amy Tippins and Julie Allred were celebrating life on a much grander scale on New Year’s Day.

Tippins and Allred were two of 30 transplant recipients nationwide who rode on the Donate Life float in the Rose Parade in Pasadena, Calif., which preceded the Rose Bowl. The float, which featured illuminating lanterns, was called “Light Up the World,” and sought to bring awareness to organ and tissue donation.

Tippins received a liver transplant in 1993 at Emory University Hospital after being diagnosed as a teenager with hepatic adenoma, a rare benign tumor of the liver. In the 20 years since her transplant, Tippins has gone on to graduate high school, college, own her own company and volunteer with the Georgia Transplant Foundation.

Julie Allred on the Donate Life Float

Julie Allred on the Rose Parade Donate Life Float

Allred, a type 1 diabetic since age 10, got her first insulin pump in 1992. Despite her efforts to carefully watch her diet and test regularly, she continued to suffer the effects of severe hypoglycemia. But thanks to two islet cell transplants at the hands of Emory transplant surgeon Dr. Nicole Turgeon and interventional radiologist Dr. Kevin Kim, Julie has experienced relief in ways she never knew possible. Soon after the first islet transplant, the episodes of life-threatening low blood sugar levels stopped for Allred, helping her get back to the things she enjoys.

Dr. Turgeon joined Allred and Tippins on the Donate Life float, which also was decorated with floragraph portraits of deceased organ donors.

“The Rose Parade float is just one of the many ways we can raise awareness of the importance, need and life-saving capabilities of organ donation,” says Turgeon. “I was thrilled to be able to both honor our donors and celebrate life with our recipients.”

Donate Life: Georgia Capitol Event Honoring Organ Donors and their Families

Donate Life Light up the WorldEmory Transplant Center patient Amy Tippins was given a second chance at life. This New Year’s Day, she’ll honor the family that saved her life in the 125th Tournament of Roses Parade. Amy, the recipient of a life-saving liver transplant, will honor that gift by riding the Donate Life Rose Parade Float.

This year’s float, with the 2014 theme of “Light Up the World,” honors donors, recipients and their families who have been involved with organ, eye or tissue donation, and hopes to serve as a platform for inspiring others to heal and save the lives of those in need.

Amy is so thankful to her donor and her donor’s family, and has made it her life-mission to be a passionate advocate for organ donation. On December 17 at 11:00 a.m., Amy and other advocates for the cause will meet at the Georgia state capitol to put the finishing touches on decorations that will become part of “Light Up the World.” Amy, along with her donor’s family, will complete a floragraph of her donor’s image composed entirely of flowers and other organic materials. The floragraph will then travel to Pasadena to be placed on the float.

Amy will be joined at the capitol by Emory Transplant Center surgeon and surgical director of the Paired Donor Exchange Program, Dr. Nicole Turgeon, along with additional members of the Emory Healthcare team, Children’s Healthcare of Atlanta, Grady Health System, Columbus Regional Health, Donate Life Georgia, LifeLink Foundation, the Georgia Eye Bank and many others involved in the organ transplantation process in Georgia.

The event is open to the public. Please visit Donate Life Georgia’s Light up the World Facebook page for details.

Related Resources:

Emory CEOs Dedicate Roses Honoring Organ Donation on Donate Life Rose Parade Float

John Fox signs a message on a rose for Donate Life Dedication Garden

Emory Healthcare CEO, John Fox, writes a handwritten message on a rose, which will be attached to the Donate Life Rose Parade Float. Thousands of roses, all with personalized messages, create the Donate Life Dedication Garden.

While the New Year is still a couple of months away, Emory is already gearing up for the first day of 2014. That’s because two Emory transplant patients and an Emory transplant surgeon have plans to ring in the New Year in Pasadena, California.

Emory Transplant Center patients Julie Allred, an islet cell recipient, and Amy Tippins, a liver recipient, have been invited to ride on the Donate Life float in the Rose Parade on Jan. 1. The float, with the 2014 theme of “Light Up the World,” honors donors, recipients and their families who have been involved with organ, eye or tissue donation.

Festivities kicked off this week when John Fox, CEO of Emory Healthcare, and Robert Bachman, CEO of Emory University Hospital, wrote touching messages thanking donors and their families for giving the gift of life. Dr. Thomas Pearson, director of the Emory Transplant Center and transplant surgeon, joined in the Rose Dedication event.

The handwritten messages are attached to individual vials that hold the roses on the float. Thousands of roses, all with personalized messages, create the Donate Life Dedication Garden.

“The rose dedication is one way we can honor donors, recipients and their families with personal messages of love, hope and remembrance,” says Bachman. “We pay great tribute to the patients and their families for their commitment to organ donation in a time of hardship.”

Dr. Nicole Turgeon, transplant surgeon and surgical director of the Paired Donor Exchange Program, will help decorate this year’s Donate Life float in California, along with Julie and Amy who will ride on the float with 28 other organ and tissue recipients.

Related Resources: