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Real Patients, Real Stories – Hear from an Emory Lung Transplant Patient

Diagnosed with Cystic Fibrosis as a baby, Kendra Adderhold struggled to have a normal childhood. Her mother brought her to the Emory Cystic Fibrosis Center for treatment and, until adulthood, things were rather stable. But, after the birth of her son, Kendra’s situation started to change. Her lung function began declining quite rapidly and soon she would need a lung transplant to survive. Hear Kendra’s story as she describes her journey to lung transplant and how the Emory Lung Transplant Program has impacted her life.

Emory Lung Transplant Program

Emory’s McKelvey Lung Transplant Center specializes in the treatment of complex lung disorders and offers the full continuum of sophisticated care involved in lung transplantation. We are dedicated to researching lung disorders and providing the best treatment and care for lung transplant patients.

Emory Transplant Center has the only lung transplant program in the state of Georgia, performing over 450 lung transplant procedures to date. Our goal is to provide patients with end-stage lung disease the unsurpassed care they deserve.

Emory Transplant Center Physicians Named 2017 Atlanta Top Doctors

Top Doctors 2017Emory Transplant Center is proud to acknowledge the transplant physicians that made Atlanta magazine’s 2017 Atlanta Top Doctors listing.

  • Seth Force, MD – lung transplant
  • Raymond Lynch, MD – liver transplant
  • Jeffrey Miller, MD – heart transplant
  • Kenneth Newell, MD – kidney and pancreas transplant
  • Andrew Smith, MD – heart transplant
  • Ram Subramanian, MD – liver transplant

Atlanta magazine’s July 2017 Top Doctors issue features the annual listing of Top Doctors in the metro Atlanta area. We are pleased to announce that of all the health systems represented in the list, Emory physicians make up half of the listing – 50% of 2017 Atlanta Top Doctors to be exact.

These physicians include those who practice at one of our six hospitals and over 200 provider locations, as well as those who hold faculty positions at the Emory University School of Medicine.

We honor, celebrate and thank all of our 2017 Atlanta Top Doctors—and their amazing care teams—for providing outstanding care to our patients and families, and for truly making patient- and family-centered care their priority each day. Congratulations to you all!

VIEW ATLANTA MAGAZINE’S LIST OF TOP DOCS

To compile the annual “Top Doctors” list, Castle Connolly uses a survey and research process involving tens of thousands of top doctors across America and the medical leadership of leading hospitals. Atlanta’s top doctors are selected after peer nomination, extensive research, careful review and screening by Castle Connolly’s doctor-directed research team. Atlanta magazine uses the research by Castle Connolly to provide detailed information about education, training and special expertise of Atlanta doctors. Doctors do not and cannot pay to be selected and profiled as Castle Connolly “Top Doctors.”

Emory Transplant Center

As one of the top 10 transplant centers in the nation, Emory Transplant Center is at the forefront of clinical excellence and pioneering new transplant therapies. The center offers cutting-edge technology and superior outcomes in heart, kidney, liver, lung and pancreas transplant surgeries. Emory Transplant Center, a part of Emory Healthcare, has performed more than 8,000 transplants to date and all solid organ programs meet Transplant Centers of Excellence quality outcome criteria. The center’s core mission is to provide exceptional care for patients in need of organ transplants while offering access to the latest transplant technology.

To learn more about Emory Transplant Center, visit emoryhealthcare.org/transplant.

Kidney Transplant Disparities

Kidney Transplant DisparitiesA new transplant allocation system designed to reduce kidney transplant disparities for ethnic patients on the waitlist. According to a research study just published in the June 2017 issue of Health Affairs, a kidney transplant allocation system that was implemented in 2014 by the United Network for Organ Sharing (UNOS) led to reduced imbalance in national kidney transplant disparities among whites, blacks, and Hispanics who were on the transplant waitlist. This new system resulted in a substantial increase in the kidney transplant rate for blacks and Hispanics in the months following implementation.

The research was conducted by an Emory team of investigators, with lead author Taylor Melanson, from Emory’s Laney Graduate School, and senior author Rachel Patzer, Ph.D., MPH, assistant professor of surgery at the Emory University School of Medicine and researcher at the Emory Transplant Center.

Kidney Transplant Allocation System

The new UNOS allocation system aimed to address the primary factor for determining a patient’s priority level on the kidney transplant deceased donor wait list; in other words, how long they have been waiting for a transplant. Minorities, on average, are less likely to complete the necessary medical evaluation to be placed on the national wait list for a transplant. Prior research has shown that this may be due to a variety of factors including poverty, limited dialysis facility staff to educate patients about transplant and physician bias.

Under the new allocation system, the starting point for calculating wait time was changed from the date of waitlisting to either the first regular dialysis date or the waitlist date, whichever was earlier. The change was expected to benefit minorities because they tend to spend more time on dialysis prior to being added to the waitlist than white patients.

Kidney Transplant Disparities Research Results

To determine the effect of the new kidney allocation system on inequality, the researchers examined 179,071 waitlisting records from UNOS from June 2013 to September 2016 and calculated monthly kidney transplant disparities among waitlisted patients.

Prior to the new allocation system, white patients were more likely to receive a kidney transplant (1.07 percent per month) than black (0.80 percent per month) or Hispanic (0.79 percent per month) patients. After implementation of the new system, the monthly rates changed significantly to 0.95 percent for whites, 0.96 percent for blacks, and 0.91 percent for Hispanics. Thus, average monthly kidney transplant disparities narrowed by 0.29 percentage points (rounded) for blacks compared to whites and 0.24 percentage points for Hispanics compared to whites, with both disparities becoming insignificant.

“The policy change appears to have at least temporarily eliminated racial and ethnic disparities in access to kidney transplantation for waitlisted black and Hispanic patients,” says Melanson. “This is a very positive achievement, but continued efforts are needed to address the disparities that exist prior to the waitlist, including the racial and ethnic differences in completing the medical evaluation process to be placed on the waitlist.”

Nearly 700,000 people in the United States have end-stage renal disease, with care for these patients costing Medicare $32.8 billion in 2014. Kidney transplantation is the preferred treatment for most patients with an end-stage disease because it offers longer survival, better quality of life and fewer hospitalizations than dialysis. Transplantation also costs about 65 percent less than dialysis annually.

“It will be important to do additional follow-up and monitoring on the effects of the UNOS policy to fully understand the longer-term consequences and maintain and improve on the disparity reductions,” notes Patzer. “If the disparity reduction is sustained, the kidney allocation system will serve as a valuable example of how health policy can be shaped to immediately reduce racial and ethnic disparities in our health care system.”

Learn more about kidney transplant at the Emory Transplant Center.

VIEW EMORY TRANSPLANT CENTER 

Good Morning America Pays Tribute to a Transplant Recipient’s Wife

It all started with a Facebook post…Raleigh Callaway, a veteran Georgia police officer and patient of the Emory Transplant Center, needed a kidney transplant. Desperate to find a match as he entered the late stages of renal failure, he and his wife, Kristi Callaway, turned to social media to find a potential donor. Kristi posted a message on Facebook sharing Raleigh’s need for a kidney. The post resulted in more than 900 people contacting the Emory Transplant Center – one of whom was Chris Carroll, a health care consultant and grandfather from McKinney, Texas. He saw the Callaway family pictured on Facebook with their two children holding a sign that read, “Our Daddy Needs a Kidney.” Chris said he felt divinely led to call to see if he could become a donor. On Thursday, September 25, 2014, Raleigh received Chris’ kidney. Both recipient and donor are doing well.

But even after her husband found a kidney, Kristi Callaway continued her mission of supporting organ donations and helping to connect individuals in need of a kidney with donors from across the country. So far she has save 23 lives by connecting kidney donors to those in need. Good Morning America recognized Kristi for her extraordinary work.

Check out the full story and the video here.

 

Emory Liver Transplant Program Ranked 2nd Nationally

Emory Transplant Center has great news to share about our Liver Transplant Program. The Scientific Registry of Transplant Recipients (SRTR) just released their January 2017 program specific reports. In this latest release, when comparing adult liver transplant centers across the nation by volume and outcomes (survival at 1 year with a functioning graft), Emory is now ranked SECOND NATIONALLY, bested only by the University of California San Francisco (UCSF).

Below is a portion of a graph that shows the top three ranked adult liver transplant centers by volume with an outcome score of ‘5’, meaning better than expected survival (survival at 1 year with a functioning graft). It is sorted from best to worst.

SRTR National Ranking – Emory Liver Transplant Program Ranked #2*


*SRTR.org

As you can see, Emory is a large volume liver transplant center which attests to the fact that we do it well and we do it often.

We have also included the outcomes results on a more local level. Emory is ranked HIGHEST in the STATE as evidenced by data in the graph below.

SRTR State Ranking – Emory Liver Transplant Program Ranked #1*


*SRTR.org

We are incredibly proud of our liver transplant team and would like to thank everyone involved who played a role in achieving this success. We are proud knowing that we give our patients the best care that can be found anywhere in the country.

cta-learn-blueabout the Emory Liver Transplant Program

Education & Outreach Increases Kidney Transplant Referrals from Dialysis Centers

two peopleBack in May, Emory Transplant Center announced that they, along with six other transplant centers and organizations in the Southeastern Kidney Transplant Coalition, were awarded $2.6 million by the National Institutes of Minority Health and Health Disparities to continue the Reducing Disparities in Access to Kidney Transplantation Community Study (RaDIANT) in Georgia for another five years and expand it to South Carolina and North Carolina.

We are excited to bring you the initial outcomes of the study. The results were published in the October issue of the Journal of the American Society of Nephrology. Rachel Patzer, PhD, MPH, assistant professor of surgery at Emory University School of Medicine, is first author, and Stephan Pastan, MD, medical director of the kidney and pancreas transplant program at Emory Transplant Center, is senior author.

The RaDIANT study is a multicomponent intervention designed to increase referral of patients on dialysis for transplant evaluation. In December 2013 the research team selected dialysis facilities with either low transplant referral or racial disparities in referral. The intervention, conducted from January to December 2014, included transplant education and engagement activities targeting dialysis facility leadership, staff and patients. These included talks at dialysis centers by former patients, and educational webinars for clinical staff about common barriers faced by patients and potential solutions.

The educational and outreach program in Georgia dialysis centers in 2014 resulted in a 75 percent increase in referrals for kidney transplant evaluation, with the greatest increase among black patients.

“This work could not have been done without our committed group of academic and community partners in our Southeastern Kidney Transplant Coalition”, says Patzer. ”The multicomponent educational and outreach intervention that our Coalition developed together substantially improved kidney transplant referral and reduced racial disparity, and we are working to adapt it for use by other ESRD networks and other members of the kidney community.”

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.

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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.

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about kidney transplant and the Emory Living Donor Kidney Program