Posts Tagged ‘transplant program’

Transforming Lives Through Transplant Research

Transplant Research at EmoryResearch conducted at the Emory Transplant Center over the years has led to medical and surgical treatments that restore the lives of an ever increasing number of transplant patients at Emory and beyond. And fiscal year 2013 was no less spectacular.

The 50 Emory Transplant Center faculty researchers and their postdoctoral students and staff stretched each research dollar to the limit, and created a lot of bang for the buck. They published 82 papers in 52 journals in fiscal year 2013, and twenty-eight faculty were principal investigators on an active award. Leading research faculty members — Drs. Stuart Knechtle, Allan Kirk, Leslie Kean, Ken Newell, and Ken Brigham — had a total of $11.9 million in funding last year to develop many advances. We are truly shaping the field.

Even with the recent government shutdown, the future of transplant research here in FY2014 looks positive. “Despite the worst year in federal research funding since 1931, the Emory Transplant Center is currently enrolling in the largest number of clinical trials in our history — 29 studies,” Carlson says, “Also, the ETC is the leading site in the country enrolling patients in a hepatic support device trial, which is directed by Dr. Ram Subramanian.” Overall, ETC faculty are participating in 45 kidney, liver, islet, composite tissue, lung, and heart transplantation and infectious disease research studies. And Emory’s transplant biorepository core is involved in 39 multicenter studies.

“In the end, the single most important factor is that the ETC has been able to sustain a high impact research portfolio that spans basic, translational, and clinical science research,” Carlson says. “We continue to be exceptional stewards of the investments entrusted to us. Congratulations to everyone involved in research for making such a big impact in FY2013, and thank you for your continued dedication to advancing the field.”

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For Emory Transplant Patient, Laughter Really is the Best Medicine

David Duncan, Emory transplant patient

David Duncan

David Duncan has many reasons to be thankful this holiday season. He recently celebrated the 15th anniversary of his kidney and pancreas transplants, and both organs are functioning with no signs of rejection. He no longer needs debilitating dialysis treatments thanks to the kidney transplant and is free from the insulin he had to take from the time he was diagnosed with diabetes at age 12 to age 39, when his pancreas transplant cured his unstable disease. But he is most thankful to the donor family who gave him a second chance at life.

“My surgeons left me with something else, too—a funny bone,” he says, cracking one of his many jokes. David has made it his life’s work as a minister, telling humorous, inspirational stories to children, and as a motivational speaker for LifeLink with the motto, “Any day above ground is a good day.”

“I went into Emory for a kidney transplant, and there must have been a two-for-one sale. I ended up with a pancreas, too,” quips David, who is 54. “I have a brand new life. The transplants lifted me out of the grave.”

Before his transplants in 1996, he was in renal failure, on dialysis and at the point that his nephrologist in Macon said he might not survive much longer without a kidney transplant. He was on Emory’s waiting list for six months before receiving a donor kidney and pancreas “from a pre-teenage girl who gave me a second chance.”

He pauses and remembers the extraordinary gifts from his donor family, “My chair is filled, but the chair for that family is empty. But they changed my life and it’s my mission to give hope to children of all ages,” says David, who serves as a chaplain for homeless, orphaned abused or neglected children.

“David is the kind of guy you love to have around,” wrote a former colleague, Pastor Bob Price, in a letter about David to the ETC. “He just makes you feel better. If someone asks him how he is doing, he might say something like, ‘If I were any better, I’d be twins!’”

There are a couple of things that could’ve dampened David’s positive attitude: He’s also a double amputee. Complications from the diabetes had left him with foot ulcers and poor circulation in his legs, which led to the amputation of one leg six years ago and the other a year later.

David and his wife, Shirley, have three daughters and three grandsons. “I don’t allow them to take care of me. I have no limitations. I’m active, watch my weight and take care of my own health—I am intentional about my meds and my life’s purpose,” he continues. “Pain is inevitable, but misery is optional.”

David writes notes each year at this time to his surgeons, Drs. Chris Larsen and Thomas Pearson, to thank them for their care. He also takes time to thank all the others at Emory who have cared for him over the years, from the front desk receptionists who are always so friendly, to the nurses, phlebotomists and doctors.

“It’s all about teamwork—they have no idea how inspiring they are,” he says. “We can’t take them for granted. Life is a gift, and it is up to each one of us to unwrap it and use it to serve others.”

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Transplant Patients Benefit from Telemedicine Follow-Up Care

Transplant TelemedicineTelemedicine, now that is a word that either sounds from the future, or a phone call you get right when you sit down for dinner. At Emory though, telemedicine and organ transplantation are two medical innovations that work symbiotically to improve access to health care, patient outcomes, and the overall well-being for our Emory transplant patients.

Beyond providing consistent care at Emory’s Transplant Center, it is imperative that transplant patients have adequate follow-up care for a successful post-transplant recovery.  Transplant patient, Ken Sutha, winner of multiple medals at the National Kidney Foundation’s U.S. Transplant Games, is living proof of the importance of follow-up care. Via telemedicine, Emory physicians stay in contact and provide guidance in keeping transplant patients like him healthy.

Patients at Emory come from all over our large state of Georgia, including many from rural areas with limited access to appropriate health care. Today, after transplant patients are discharged from the hospital following surgery, they have the option to get their laboratory test and clinic visits done virtually over a telehealth network. This allows us to serve our transplant patients, and especially those outside of Atlanta with convenient and effective follow-up care.

Emory started its transplant telehealth program in January 2009 in an effort to increase access to health care throughout the state and in the past three years, it has seen substantial growth. Kevin Clark, Emory’s transplant department business manager, said the program is on track to have nearly 100 encounters with patients this year.

“We looked at 41 patients over the past couple of years to get an idea of true benefit and what we found was that these patients actually saved about 9,400 miles of drive time,” Clark said. With 33 patient presentation sites around the state of Georgia, transplants patients from Florida are also making use of the telehealth network. Ocala, Florida, resident Frank Brickey traveled to Tifton, Georgia, regularly for evaluations with his Emory transplant physicians following a kidney transplant in October 2008. Rather than making the six-hour drive to Atlanta for each visit and staying overnight, he only had to drive three and half hours and could make it a day visit.

“There is no waiting time, you just went right in and they take your vitals and you sit down in front of the teleprompter on the screen and communicate with the doctor face-to-face,” Brickey said. “It is very beneficial in that they know about you and it’s neat to have that contact with them. It is very reassuring.”

Brickey and other patients have said the staffs at telehealth sites are professional, easy to work with,and relatable, making this post surgery option an easy and steadfast choice. Being able to stay in contact with the physicians who actually performed their transplant procedure proved to be a huge benefit when complications arose, or just for the
peace of mind of communicating with the doctor who knows the patient best.

“I would definitely encourage anyone that has had a transplant at Emory or anywhere else that they stay close to the team that worked on them, with their physician and with their coordinators,” Brickey said.

Since Emory started its telehealth initiative, the program has seen substantial growth, a true tribute to not only the system, but the doctors, nurses, technicians, and patients, all who collaborate together to make telehealth not only successful, but revolutionary, for the post-transplant care.

To learn more about the Emory Transplant Center, visit: http://www.emoryhealthcare.org/transplant-center/index.html target=”_blank”

Top Transplant Doctors in Atlanta are at Emory

Each year, Atlanta magazine recognizes the top doctors in the metro Atlanta area as ranked by a thorough physician-led research process. The 2011 Atlanta Magazine Top Docs list included 318 doctors from across the Atlanta area and across specialties, highlighting the cream of the crop in specialties ranging from pediatric to geriatric services and everything in between. We’re very pleased to announce that not only can you find over 100 of the doctors recognized this year here at Emory, seven of them are our very own transplant team members!

Our Emory Transplant Center and its physician team are unique in that they are part of a multidisciplinary team providing care in seven core transplant specialty areas: kidney transplant, pancreas transplant, heart transplant, hand transplant, islet transplant, liver transplant & lung transplant. All of our doctors here at Emory Healthcare play a role in changing and saving lives, but often times our transplant team and the treatments they provide touch the lives of our patients and their families on a deeper level. And more often than not, receiving treatment from our transplant specialists is their last, if not only option. Thankfully, based on our program’s rankings, both from a statistical post-transplant quality outcome perspective, and the perspective of the physician research team, researchers at Castle Connolly Medical LTD, and Atlanta Magazine, the Emory Transplant Center is a great option to have.

We again congratulate each of our transplant surgeons for their dedication to providing outstanding patient centered care for our patients and families faced with less than idea circumstances that can warrant organ transplantation. It is because of our multidisciplinary team of transplant specialists and their compassion, that recognition such as the Atlanta Top Doctors rankings is given. If you’d like to shout out a particular transplant doctor who has impacted your life, please do so in the comments below. You can also find the listing of transplant surgeons recognized in this year’s rankings below. If you’re interested, check out the full list of Emory Healthcare doctors recognized as the best doctors in Atlanta.

Pancreas & Kidney Transplant Doctors:

  • Chris Larsen, MD, DPhil – Transplant Surgeon
  • Kenneth Newell, MD – Transplant Surgeon

Liver Transplant Doctors:

  • Stuart Knecthle, MD – Transplant Surgeon

Lung Transplant Doctors:

  • Seth Force, MD – Transplant Surgeon

Heart Transplant Doctors:

  • Andrew Smith, MD – Transplant Surgeon
  • Javed Butler, MD – Cardiologist

Hand Transplant Doctors:

  • Linda Cendales, MD – Transplant Surgeon

 

 

 

Hope for Kidney Transplant Patients Confirmed with FDA Approval of Drug Discovered at Emory

After decades of research and testing, the FDA approves belatacept, and a new class of transplant drugs first discovered by Emory doctors.

Back in September, Dr. Christian P. Larsen, Director of the Emory Transplant Center, shared a story with you here on our blog about belatacept, a new medication that was being studied to determine its ability to help block the immune system from graft rejection after kidney transplants. It’s been less than a year since we shared that story on belatacept with you, and since that time, the FDA has now approved belatacept for use for that exact purpose.

Christian Larsen, Emory Transplant Center Director

Dr. Christian Larsen, Director of Emory Transplant Center

Dr. Thomas Pearson

Dr. Thomas Pearson, Surgical Director, Kidney Transplant Program

Since the early 1990s, Emory surgeon-scientists Christian P. Larsen, MD, DPhil and Thomas C. Pearson, MD, DPhil have been searching for ways to promote immune tolerance of a transplanted organ. In collaboration with other Emory researchers and researchers at Bristol-Myers Squibb, they played a leading role in discovering belatacept and driving its development. The recent FDA approval of use of belatacept is the first time a new class of drugs has been developed for transplant since the 1990s.

So what led to this approval of a new class of drugs? From a research perspective, in the 1990s, Larsen and Pearson found that CTLA4-Ig, a fusion protein of which belatacept is a modified type, could control graft rejection in mice, but found that it didn’t work as well in non-human primates. Bristol-Myers Squibb researchers then developed a panel of hundreds of modified forms of CTLA4-Ig, and sifted through the mutated proteins to find two that could make CTLA4-Ig bind tighter to its target and work more effectively. Larsen and Pearson then showed that the enhanced version could prevent graft rejection in a non-human primate model for kidney transplant at Yerkes Research Center.

Once the determination was made that modified versions of the CTLA4-lg fusion proteins could work to prevent graft rejection on primates, belatacept was developed and tested. In two parallel studies with more than 1,200 participants over two years, patients taking belatacept had similar graft survival rates to those taking the calcineurin inhibitor cyclosporine, while maintaining higher kidney function and lower blood pressure and cholesterol. In addition, belatacept can be given every few weeks, in contrast to calcineurin inhibitors, which must be taken twice a day.

There is still room for improvement, though. Compared with cyclosporine-treated patients, belatacept-treated patients had a higher rate of early acute rejection – a temporary flare-up of the immune system against the donated kidney. However, in most cases the acute rejection was successfully treated with drugs and did not lead to graft failure. The Emory Transplant Center team is researching approaches to reduce this risk.

“Our goal is to achieve a normal life span for kidney transplant patients, and have them survive dialysis-free,” Larsen, Director of the Emory Transplant Center, says. “We believe belatacept can help us move toward that goal.”

Clinical trials are now also being conducted to determine if belatacept will have similar positive outcomes on liver transplant and pancreatic islet transplant patients.

For more information on belatacept, you can check out the video below. If you have additional questions, leave them in the comments for Dr. Larsen or Dr. Pearson and we’ll make sure they see them and give you a response!

For more information on the FDA’s approval of belatacept, visit: http://shared.web.emory.edu/whsc/news/releases/2011/06/fda-approves-transplant-drug-that-preserves-kidneys,-avoids-toxicity.html

Emory Performs First Hand Transplant in Georgia & Southeast, 14th Procedure in U.S.

Hand Transplant Story

A truly ground breaking procedure took place here at Emory this weekend. Transplant surgeons at Emory University Hospital have successfully completed the program’s first hand transplant. Not only is the complete hand transplant a first for Emory, but also the first hand transplant in the Southeast and only the 14th such procedure in the country. Emory transplant specialists performed this rare complete hand transplant procedure for a 21-year-old student out of Florida whose arm was amputated at the age of 1 due to Kawasaki Disease.

The hand transplant surgery lasted for 19 hours on Saturday, March 12 and involved a true multidisciplinary effort, including two teams (one dedicated to the patient and one to the donor arm) of transplant surgeons, specialists, nurses, and support staff. Since completion of the hand transplant, the patient has begun rehabilitation at Emory and will continue to rehabilitate in Atlanta for the next several months. As an IT major, when asked how the transplant would impact her life, her face lit up as she said, “I just want to be able to type.”

Emory’s Hand Transplant Program, established in 2007, is led by Dr. Linda Cendales, the only person in the United States with formal training in both hand and transplant surgery. Cendales is responsible for organizing the team that performed the first hand transplant in the U.S. and joined the Emory team from a program in Louisville that conducted 6 of the hand transplantations performed in the U.S.

If you have questions on the procedure or Emory’s Hand Transplant Program, please leave them in the comments section below.

Emory Transplant Center Achieves and Sustains Outstanding Quality Outcomes

Transplant Center OutcomesThe idea of replacing an organ via transplant can be a scary topic for people faced with a condition that may require one. At Emory, we’re consistently taking steps to improve transplant survival rates and hopefully, remove some of this fear for our patients. We’ve just received results from the January 2011 transplant center-specific report on outcomes from the Scientific Registry of Transplant Recipients (SRTR). We’re very pleased to announce that the Emory kidney transplant program, liver transplant program, and lung transplant program have all demonstrated consistently strong and in some cases better-than-expected patient outcomes.

Kidney Transplant

  • Emory’s overall one-year graft survival rate of 95.85% for the most recent cohort studied (July 2007 – December 2009) is statistically higher (p = .026) than the expected rate of 92.81%.
  • Emory’s living-donor graft survival rate of 100% is statistically higher (p =.033) than the expected rate of 96.36%.
  • Emory’s deceased donor graft survival rate is also numerically higher than expected (93.69% observed vs. 90.95% expected).

We’re pleased to also note that in 2010, the Emory transplant team performed 207 kidney transplants, and 22 pancreas transplant procedures – the largest number of transplants in the history of the kidney and pancreas transplant program. Of the 207 kidney transplants, 31% (64) involved living donors.

Lung Transplant

  • Emory’s one-year patient survival rate for the latest cohort (July 2007 – December 2009) is 90.14%, compared to a risk-adjusted expected rate of 82.74%.
  • Emory’s graft survival rate is 85.29%, compared to a risk-adjusted expected rate of 81.10%.

This past year, the Emory Transplant Center and team of transplant doctors performed its 300th lung transplant. The lung program has come a long way to reach this milestone, performing 35 transplants in 2010, a 300% increase over the annual total just 10 years ago.

Liver Transplant

Emory’s liver transplant program continues to achieve and sustain outstanding outcomes, with patient survival rates >91% following transplantation.

Since July 2008, our surgical transplant team has performed 241 liver transplantations (216 liver only, 25 liver/kidney combination transplants). Between January 1, 1988 – November 30, 2010, Emory has performed 67.9% (1,496 of 2,203) of all liver transplants in the state of Georgia.

Our transplant center continues to excel with statistically significant patient organ transplantation outcomes, demonstrating a commitment to high quality and patient success. If you have questions about our transplant program or outcomes, please leave them in the comments section below.

Jo Ellen Kimball – the Miracle of Transplant

Jo Ellen Kimball became somewhat of an Emory University Hospital celebrity when she became Emory Healthcare’s 300th lung transplant patient since the lung transplant program‘s creation more than 17 years ago in 1993. In this video and slideshow, Kimball tells her story and thanks the transplant team and the family of the organ donor.

For more information on Emory Healthcare’s transplant program, visit our transplant center website.