Posts Tagged ‘liver transplant’

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.

Liver Transplant Recipient Celebrates Silver Liverversary

patient story 8-11On July 2, Terri Willis celebrated her 25th anniversary with her transplanted liver. Over the years, Willis, who lives in Douglasville, has become one of the Emory Transplant Center’s most vocal advocates on the benefits of organ donation and liver transplantation, talking to other transplant candidates and recipients, participating in many transplant events and writing about her experiences on Facebook and blog posts.

“If someone had not said yes to organ donation, I would not be here,” she says.

Willis had her liver transplant at age 13 at Children’s Healthcare of Atlanta at Egleston, but she has been an Emory Transplant Center patient since 1999. Her liver failed 25 years ago as the result of a metabolic disorder called tyrosinemia, a genetic defect that causes the immune system to break down the amino acid tyrosine, the building block of most proteins. When tyrosine and other byproducts build up in the tissues and organs, it can lead to nosebleeds, dietary issues, problems with the central nervous system, liver and kidney failure, and hepatocarcinoma. Willis developed tumors throughout her liver, and her transplant saved her life, keeping the cancer from spreading to other organs.

Willis has been running for years to stay in shape, and has participated in five U.S. Transplant Games mostly in track and field events. She is an inspiration to other recipients — to everyone who has ever heard her story.

Willis remains optimistic, even though she is currently experiencing a few issues with her liver and kidneys due to her medications and the age of her organ graft. The road hasn’t always been easy. She had two quickly resolved episodes of rejection in the mid-1990s and one eight-month long episode this year that has been more of a setback. But she keeps her positive attitude and shows other transplant recipients what a little grit can do by continuing to walk and run. “I want other patients to see that they can be active post-transplant,” she says. She ran Douglasville’s Hydrangea Festival 5K road race on June 5 in a specially made t-shirt in celebration of her upcoming liverversary. She gave her finisher’s medal to her longtime transplant hepatologist, Dr. Samir Parekh, who is pictured above with Willis.

Emory Liver Transplant Patient Celebrates One-Year Liver-versary

UntitledAll of our patients are pretty special, but there is something extraordinary about a liver transplant recipient who comes all the way from Gaffney, S.C. to host a party to thank the medical team who cared for her while she was at Emory Transplant Center.

Evonne Leland received a lifesaving liver transplant on April 22, 2015. She came back on the same date one year later — this time in good health — to celebrate what we at the Emory Transplant Center like to call a one-year “liver-versary.” A former restaurant owner, Leland, with help from her family and friends, organized a lunch to thank Emory Transplant Center staff and physicians. It was a true celebration of life.

“Before I came to Emory,” Leland says, “I was told there was nothing I could do; I had only six to nine months to live.”

Throughout the mid-1990s, Leland had one medical issue after another, resulting in many visits to doctors. In 2001, Leland learned she had an abnormal finding on her liver, and by 2009, her liver began to fail. In 2014, Leland was diagnosed with hepatocellular carcinoma (HCC) and placed on the liver transplant waitlist in Charlotte, NC. Due to her health status at that time, she had to be taken off the list. She subsequently sought a second opinion at another hospital in North Carolina, but she was told her cancer was out of the criteria for a transplant there.

Leland then made a call to Emory Transplant Center and was able to make an appointment right away with the Emory Liver Tumor Clinic. “Mrs. Leland came here on April 2, 2015 and because we have a multidisciplinary clinic, we were able to arrange for the right specialists to evaluate her and obtain the necessary imaging studies to evaluate her liver cancer,” says Dr. Anjana Pillai, a transplant hepatologist and director of the Liver Tumor Clinic. “She was able to see the specialists she needed and we were able to make the decision to admit her that same day and expedite her liver transplant evaluation.” The Emory Liver Tumor Clinic was opened three years ago and has coordinated a multidisciplinary team of transplant hepatologists and surgeons, medical oncologists, palliative oncologists, interventional radiologists, and advanced practice providers to care for HCC patients.

Leland received her transplant only three weeks after her first visit to Emory. It has been a difficult road over the past year, but she is an example of how the Emory Liver Tumor Clinic’s multidisciplinary team works with each patient with HCC, or tumors originating in the liver, to determine a care plan that is best for him or her. Leland has made a remarkable recovery.

“I am so grateful for my transplant,” Leland says. “When so many doors were closed, Emory opened one for me.” Dr. Joe Magliocca, surgical director of the liver transplant program, was her surgeon.

The Emory Liver Tumor Clinic treats patients with HCC, which often is the result of cirrhosis, or liver scarring, from chronic liver disease and decompensation. Patients with early-stage HCC and cirrhosis treated with liver transplantation have a five-year survival rate of 75%, compared to only 25% to 30% without a transplant. HCC is a growing problem in the U.S.

According to Leland, “It was so nice to see the staff again now that I am so much better. I get up in the morning, and I can hold up my hands and they work. I can get out of bed and my legs work. And I don’t have to be on dialysis any more. I am so happy at what I can do. Each milestone is so very important. I’m getting there!”

Giving the Gift of Live: Understanding Organ Donation Live Chat- April 12, 2016

organ-donor260x200April 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.

To get the facts and learn more about organ donation, join Sharon Mathews, MS, RN, CPTC, of the Emory Transplant Center for a live chat on Tuesday, April 12th 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 Emory Transplant Center’s living donor and paired donor exchange programs.


Improving Survival Rates for Liver Cancer Patients

250x250liverEmory is nationally renowned for using a multidisciplinary approach to treat cancer. But many may not know there is a multidisciplinary team right here at the Emory Transplant Center with the mission of improving survival rates for liver cancer. Hepatocellular carcinoma (HCC) is a form of liver cancer. It accounts for most liver cancers and is among the fastest rising cancers in the U.S. According to the National Cancer Institute, liver cancer is the third leading cause of cancer deaths worldwide and the seventh leading cause of cancer deaths in this country. For patients with early-stage primary HCC, liver transplantation may be their best chance of survival.

“Data here [at the Emory Transplant Center] and at other major academic transplant centers are showing that the five-year survival rate for patients with early-stage HCC and cirrhosis who receive a liver transplant is 75%, but only about 25-30% without a transplant”, says Dr. Anjana Pillai, a transplant hepatologist and the Medical Director of the Liver Tumor Clinic at Emory University Hospital.

Emory opened the multidisciplinary Liver Tumor Clinic, the only program of its kind in the state, in May 2013. It consists of a team of transplant hepatologists, liver transplant surgeons, interventional radiologists, midlevel professionals, palliative oncologists, medical oncologists and others who help personalize treatments depending on patients’ individual needs. Emory Transplant Center hepatologists serve as care coordinators for liver cancer/tumor patients. The reason transplant hepatologists are well suited to coordinate care for this population is they treat on a daily basis patients with chronic liver disease, liver failure and those requiring liver transplants.

“It’s a great group of people — the team takes each case step-by-step and determines the course that is best for each patient and family,” remarks Dr. Pillai.

It is better to treat patients with early-stage HCC with transplantation. According to OPTN/UNOS statistics, about 1,300 liver transplants were performed for liver cancer patients in the U.S. in 2012.

According to Dr. Thomas Pearson, Emory Transplant Center Executive Director, “The liver transplant program exemplifies multidisciplinary team management for this growing patient population, and their efforts are showing promising results. According to transplant center reports released by the SRTR [Scientific Registry of Transplant Recipients] in June and December 2015, the Emory liver transplant program’s one-month, one-year and three-year patient and graft survival rates are the highest they have ever been since SRTR began publishing data in November 2001 [cohort: 7/1/1995-6/30/1999]. I’m really proud of how far the team has come, and I’m excited to see what the future holds for a liver cancer patient population that is managed by our multidisciplinary team of transplant hepatologists and surgeons, interventional radiologists, medical oncologists, palliative oncologists, and advanced practice providers.”


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.

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.”

Emory Transplant Center Patients Represent Georgia in the Transplant Games of America

Transplant Games of AmericaThe competition was fierce this summer in the muggy Texas heat as Team Georgia participated in and watched athletic competitions at the Transplant Games of America at Rice University in Houston.

The team had 27 athletes representing six transplant centers from Georgia as well as 32 sports fans cheering on the athletes. The team had three donor family members, four living donors, 19 organ transplant recipients, and one cornea recipient who all brought home a total of 48 medals. Co-captains Joe Stott (heart recipient, Emory) and Sherrell Gay (heart and heart/kidney recipient, Emory) led the delegation.

We are so proud of our Emory Transplant Center athletes that we just couldn’t resist listing their names.

Here were their accomplishments:

Heart Transplant

  • Doug Austin — doubles golf (silver) and singles golf
  • Tim Lamberg — singles golf (gold), doubles golf (silver) and 5K run/walk
  • Joe Stott — singles bowling (bronze), 5K and doubles bowling
  • Richard Walker — mixed doubles tennis (gold), singles tennis, table tennis, and 5K
  • Malia Veator — 5K (gold), 1500m (gold), 100m (silver), 800m (silver), and mixed doubles tennis (gold)


  • Sherrell Gay — cornhole game, table tennis and 5K


  • Kevin Schneider (living donor) — singles golf (gold) and trivia games

Liver Transplant

  • Sharon Jean Cyprien — 400m (gold), 200m (gold) and 100m (silver)

Lung Transplant

  • Keith Harris — 5K and singles golf

“We feel our supporters/fans are so important to our wellbeing,” reports Gay, “so I have to mention we had two mascots. Tim Lamburg’s daughter dressed as ‘Peachy’ and Joe Stott’s 84-year-old mother-in-law was ‘Mrs. Peanut.'”

Way to go, Team Georgia!

Emory Transplant Center Performs First Triple Organ Transplant Procedure in Georgia

The team at the Emory Transplant Center has performed more organ transplants in the state of Georgia than any other transplant center. Because the Georgia community trusts the expertise of our transplant team, we have performed some of the most complex transplant procedures in the area. Our team performed the first hand transplant in the state of Georgia and the Southeast, for example, and we’ve performed over half of the multi-organ transplants in Georgia. While you’ve seen us share stories like that of Jo Ellen Kimball and her double lung transplant, multi-organ transplants are rare, making up just over 1% of all transplant procedures conducted in Georgia since 1988. But even more rare, is a double transplant involving a heart and a liver, with only 60 of these procedures having been performed in the U.S. And even more rare, a triple transplant, involving the transplantation of a heart, liver and kidney.

Stephanie Lindstrom

Stephanie Lindstrom

Today, thanks to a triple organ transplant, a 37-year-old mother of two in Georgia is celebrating Christmas with a renewed spirit of hope and thankfulness this year. Just five months ago, Stephanie Lindstrom received a triple organ transplant at Emory University Hospital, the first triple transplant ever to be performed in the state of Georgia.

Following a lifetime battle of congenital heart complications, Stephanie’s condition became critical this summer when she was told she would need not only a new heart, but that she would also need a new liver and kidney. All other interventions to help her were not successful.

“Because of Stephanie’s heart failure, she developed liver failure. Then she became septic, which led to kidney failure. So a triple organ transplant was our only hope to save her,” says Stuart Knechtle, MD, professor of surgery at Emory University School of Medicine and director of the Adult Liver Transplantation Program.

Stephanie, a former marathon runner, was born without a tricuspid valve, which helps move blood through the heart in the right direction. She had four surgeries as a child to repair the problem. After she graduated from college, more heart valve problems occurred, but this time, with her mitral valve. Doctors diagnosed Stephanie with mitral valve regurgitation and said it needed to be corrected.

Stephanie, who lives in South Carolina, scheduled an appointment with Wendy Book, MD, associate professor of medicine at Emory and medical director of Emory’s Adult Congenital Heart Disease Program. “When I first met Stephanie, I immediately knew she was a resilient, strong willed person who was a fighter,” says Dr. Book. “We knew her heart and liver were in bad shape because of her congenital complications, but problems with her kidney had not yet surfaced.”

In September 2011, Stephanie was placed on the waiting list for a heart and a liver. In May 2012, she contracted cytomegalovirus, and was admitted to the hospital to be put on dialysis and breathing machines. At that point, she was moved up on the waiting list for her new organs, which now included a kidney.

On July 7, 2012, doctors got the call that a match had been found for Stephanie. On that day, both her heart and liver were transplanted during a lengthy surgery.

First Brian Kogon, MD, surgical director of the Adult Congenital Heart Disease Program transplanted her new heart, assisted by David Vega, MD, director of Emory’s Heart Transplant Program. Then Knechtle and transplant surgeon Andrew Adams, MD, transplanted the liver. The following day, Knechtle transplanted her kidney. All three organs came from the same donor.

“The risks for a triple organ transplant are very high for a patient with a three-system failure, and one we had never attempted before,” says Kogon. “Her previous surgeries and critically-ill state at the time of the transplants made things challenging. But Mrs. Lindstrom’s age and determination to survive made her an ideal candidate for these procedures.”

Stephanie spent the next three months at Emory University Hospital recovering, while battling complications. She was able to return home in October 2012, five months after she was admitted.

“I am so grateful to the doctors, nurses and support staff who made these transplants possible,” says Stephanie. “They have given me a new lease on life. The holiday season has truly taken on such a special meaning to my family and me this year because of the many gifts we have been given.”

“Whatever Doesn’t Kill Me Had Better Start Running!”

Terri Lynne Transplant Patient & Dr. Dodson Transplant Surgeon

Terri Lynne giving her medal from the GA Transplant Games to her transplant surgeon, Dr. Dodson

Georgia native and Douglasville resident, Terri Lynne was born with a rare disease called Tyrosinemia, it is a genetic disorder characterized by elevated blood levels of the amino acid tyrosine, a building block of most proteins.  Terri’s disease caused her liver cancer that led to a liver transplant at the age of 13.   As a child, Terri had her transplant at Children’s Healthcare of Atlanta at Egleston and was performed by Emory’s Dr. Thomas Dodson, who started the pediatric liver transplant program in 1990.  Terri was only the 8th pediatric liver transplant in Georgia.  It’s been 20 years since Terri’s transplant, and she feels it is important to give back to the transplant community. So much so, in fact, that when Terri visits the Emory Transplant Center for her own appointments, she frequently shares her story and answer questions for people who are just beginning their own transplant journey. It’s her mission to let others know that even after undergoing a transplant, there are no limitations in what they can do.  In Terri’s case, she set not a long-term goal, but rather a long distance goal, to participate in her first marathon after receiving her transplant.

In her first attempt in making strides towards her goal, Terri signed up to run in a 400 meter race at the GA Transplant Games- but she was unable to finish the race.  That’s when Terri made it her mission for the next year to run the whole thing. She began taking baby steps towards her long distance goal in 2006 when she says, “I ran the first mile ever in my life and I couldn’t stop.”

Terri chose the Marine Corps Marathon in 2007 as her ultimate test.   “The final push for me to sign up came when a fellow transplant friend dared me to do it.  He told me he would shave his head if I ran the whole thing. Given my transplant and medical history, I wasn’t sure if I could do it but I wanted to find out.”

Terri finished the marathon in 6 hours and 6 minutes.

Now, when Terri visits the Emory Transplant Center and passes the inspirational photos of transplant recipients that have always graced its wall, she has something to celebrate.  “One of them is of me; I am crossing the finish line of that marathon.  A Marine gave me my finish medal; I gave him a hug and started crying, I couldn’t believe it. Sometimes, I still don’t believe it.”

And despite her improved health, Terri continues to visit the Emory Transplant Center, both as a patient and an ad hoc advocate who is always willing to share her story and inspiration with other patients on her own visits.  “I have been going to Emory and Egleston since I was two years old; it is all I have ever known.  In the last three years I have had some issues with my liver and kidney numbers. It can be scary sometimes, but my coordinator Dianne [Dianne Thackston] has been very understanding, compassionate and has helped me deal with it. I wouldn’t trust my care to anyone but Emory!”, says Terri.

And in the true spirit of giving back in the way she was given to, Terri even donated one of her own medals from the GA Transplant Games to her surgeon, Dr. Dodson.  “I wanted to surprise him. I made him close his eyes, put the medal around his neck and said, ‘I won this for you’. It was a small way of saying thank you for saving my life and being able to do that made my day.”