The UC Health transplant team has continued to perform organ transplants during the COVID-19 pandemic and launched a new program for living donor liver transplants.
During one week in April, UC Health transplant surgeons performed three dual organ transplants, potentially extending the lives of patients suffering from organ failure. While the kidney-liver, kidney-pancreas and kidney-heart transplants are common procedures for UC Health, during the COVID-19 pandemic, they were anything but routine.
According to the United Network for Organ Sharing (UNOS), living kidney donor transplants dropped by 89% and deceased donor transplants fell by 35% in April as many hospitals across the nation canceled or postponed procedures to limit the spread of COVID-19 and conserve space and resources in health care facilities, The organization’s data also counted 94,822 patients waiting for a kidney transplant; in April 2019, 23,401 transplants were performed.
As transplants decreased nationally, UC Health remained a beacon of hope for the region by continuing to perform essential transplants. UC Health was able to continue transplanting, in part, due to the fact that the Greater Cincinnati region did not see a large surge of COVID-19 patients during the initial months of the pandemic and because of its overall partnership with local health systems to contain the virus.
While continuing to provide second chances to those who needed it most, the transplant team was dedicated to ensuring the health and safety of all patients and medical professionals involved. UC Health also moved forward during the pandemic to launch a long-planned new living donor liver transplant program in July, adding to its reputation as a national leader in organ transplantation. UC Health is the region’s only comprehensive transplant program for adults, providing heart, liver, kidney and pancreas transplants. The liver and kidney transplant program volumes rank among top in the nation, and in February 2020, UC Health performed its 30th heart transplant since restarting the program in 2016.
“Our volume has remained busy during the pandemic,” says Shimul Shah, director of UC Health’s Division of Transplantation. “Only living donor kidney transplants were postponed from March 14 to about May 1 for donor and recipient safety. All other transplants continued with care and protocols for protection and safety against the pandemic.”
In 2019, UC Health set a record for the number of transplants performed, with more than 320 people receiving organ transplants, marking an eighth consecutive year of growth. There were 133 liver transplants and 183 kidney transplants, including 59 transplants from living donors. UC Health attributes the increase to improved outreach to referring physicians and rising local and national rates of organ donation. A new record was also set for living donor kidney transplants, with an 11% increase from 2018.
In clinical research, the UC Health team in 2019 performed the first liver transplant in the nation
that used a donor organ preserved through a mobile cold perfusion pump. The technology, which sends a specially formulated solution through the donor organ for preservation before transplant, had gone through pilot testing at UC Medical Center and other centers across the country. This technology will help preserve organs longer than simply storing them on ice.
To maintain its 2019 transplant volume into 2020, UC Health adjusted certain processes in the pre- and post-transplant protocol to align with public health guidelines to limit the spread of COVID-19. The changes affected both living donor transplantation and deceased donor transplantation procedures.
After a transplant, patients are typically seen in-person multiple times per week for several weeks to ensure the new organs aren’t being rejected and that the patient is recovering well. Those post-transplant outpatient appointments now take place through telemedicine, as do pre-operation appointments to discuss treatment plans and procedures.
Transplant support groups that used to take place in person are also conducted virtually. In these groups, recipients, donors and patients waiting for transplants can connect with and ask questions of their medical team, which often includes a nephrologist, transplant surgeon, social worker and administrative and coordinator team member.
UC Health performed 183 kidney transplants in 2019, a number which included patients seen at outreach clinics across a 200-mile radius from Cincinnati. As many as a third of all transplants are from patients initially evaluated in outpatient clinics in Dayton and Portsmouth, Ohio, and Lexington and Louisville, Kentucky, giving more patients greater accessibility to UC Health services, particularly those in rural areas. Currently all outreach clinic outpatient visits are now taking place virtually, but the clinics were already offering virtual visits by phone or teleconferencing to patients during the past two years. Familiarity with telemedicine made it easier for the clinics to switch gears to a fully virtual outpatient format.
Looking ahead, the new living donor living program will offer more opportunities for those on the waiting list to receive the transplant they need, including helping some patients not acutely ill enough to qualify for a deceased donor liver, but who could benefit from a family member choosing to be a living donor.
“Our goal is to provide access to transplantation for our patients and this program offers another avenue for liver transplantation,” Shah says. “We have a high mortality on the waiting list and a shortage of potential organs for our patients.”
According to UNOS, nearly 9,000 people are on the national liver transplant waiting list. At UC Health, the living donor transplant program is designed to provide patients and families with options not available elsewhere in the region.
“Thanks to the strength of our team and the expertise of our surgeons, we are proud to be able to take on the responsibility of allowing a healthy person to donate part of their liver and provide more hope to patients who need it most,” Shah says.
UC Health’s new program is designed to provide patients and families with hope and options not available elsewhere in the region.
For more information on UC Health and its transplant program, visit www.uchealth.com/en/transplant.