Healthcare, WVU News

A Step Forward

WVU Medicine begins to evaluate candidates for kidney transplants

WVU Medicine is evaluating kidney transplant candidates as it moves closer toward becoming the first medical center in West Virginia to perform multi-organ transplants.

The medical center performed its first heart transplant earlier this month on a 61-year-old Ohio man and completed at least one more heart transplant since.

Kidney transplants could be underway possibly by the first quarter of next year, said Michael Shullo, Pharm.D., WVU Medicine associate vice president of transplant services.

In late October, WVU Medicine said it received approval from the United Network for Organ Sharing — the private nonprofit scientific and educational organization that administers the Organ Procurement and Transplantation Network in the U.S. — to perform kidney transplants. UNOS approved WVU Medicine for heart transplants in September.

The idea behind offering heart and now kidney transplants is to keep residents in state and to encourage them to seek medical care.

As of Friday, there were 268 West Virginians on the national kidney transplant list, Shullo said. And the need for kidneys is critical.

“West Virginia has one of the highest rates of hypertension and diabetes in the country,” said Dr. Lynsey Biondi, physician director of transplantation and surgical director of kidney transplant at WVU Medicine, explaining these are the two largest causes of kidney failure. Other causes of kidney failure include cancer, injury, autoimmune diseases, genetic diseases and chemotherapy.

Shullo and Biondi said the decision to perform kidney — and heart — transplants in Morgantown is not to compete with Pittsburgh health care giants, UPMC and Allegheny General Hospital, or transplant centers in any of the contiguous states.

“People deserve health care,” Biondi said.

The Charleston Area Medical Center has performed kidney transplants since 1987. The bulk of CAMC’s patients come from the southern part of the state. WVU Medicine’s kidney patients, meanwhile, come from north and central West Virginia.

According to UNOS, as well as the U.S. Department of Health and Human Services Organ Procurement and Transplantation Network, more than 670,000 people in the U.S. have end-stage renal failure. There are also more than 100,000 people waiting for a kidney transplant, but only around 21,000 kidneys become available.

Transforming WVU Medicine into a center for kidney and heart transplants was a goal of CEO Albert Wright when he arrived in Morgantown five years ago, Shullo said.

Pre-surgery tests and other matters

Before undergoing a kidney transplant, numerous medical tests need to be done, and can take several months to complete, according to the National Kidney Foundation. These tests include blood work, tissue typing, dental exam, electrocardiogram, echocardiogram, chest X-rays, cancer screening, colonoscopy, prostate exam for men and gynecological exam for women.

In addition, the transplant candidate will meet with some or all members of the transplant team, which could include the surgeons, social workers, dietitians and financial coordinators.

“Transplantation is the ultimate team sport,” said Shullo, who was recruited from UPMC to develop and oversee WVU Medicine’s transplant program. Biondi was recruited from Florida.

“We’ve had to decline some top-notch talent,” Shullo said.

Ideally, Biondi said as many as 60 kidney transplants could eventually be performed at WVU Medicine each year. She said it will take a while before the 60 mark is reached.

“We’re going to be starting small at first,” Biondi said.

Kidneys used for transplant surgery come either from a living or deceased donor. In most cases, the organ is placed into a patient within 24 hours. Biondi said.

Kidneys from living donors tend to last 15 to 20 years, nearly double that   from a deceased donor, the National Kidney Foundation said. People may wait as much as five years for a deceased donor kidney.

Cost of a kidney transplant can run anywhere from $80,000 to $100,000, Biondi said. By comparison, hemodialysis costs Medicare an average of $90,000 per patient annually in the United States, according to the Kidney Project at the University of California at San Francisco. Sessions are usually three times a week and last anywhere from three to five hours.

Shullo said WVU Medicine has no plans to transplant other organs such as livers and pancreases. Instead, because of the need in West Virginia, it was decided to focus on the heart and kidney.

“Patients who previously spent several hours each week undergoing dialysis treatments get that time back to spend with their families and do the things they love to do,” Biondi said. “We get to give patients their lives back and families their loved ones back. There’s no greater honor than that.”