Striving for excellence: UF Health’s kidney transplant program maintains favorable outcomes
UF Health Shands Hospital’s kidney transplant program has demonstrated favorable outcomes, according to a recent report from the Scientific Registry of Transplant Recipients, or SRTR.
The results, released in January by SRTR, a database operated by the Minneapolis Medical Research Foundation that analyzes organ transplantation nationwide, measured transplant outcomes over a 30-month period. According to SRTR’s Program-Specific Report, 179 adult patients received kidney transplants between July 1, 2013 and Dec. 31, 2015 at UF Health. The analysis showed 97.8 percent of those patients were alive with a functioning transplant at the one-year mark; the expected rate for UF Health was 95.2 percent.
At UF Health, kidney transplant rates are higher than the national average — 19 out of 100 people per year, compared to 17.4 people out of 100 nationally. Patients here also spent less time on the waiting list than the nationwide average. Within three years, 38.5 percent of UF Health patients received a kidney transplant, compared to 22.6 percent of patients nationally, according to the SRTR report.
The registry releases its program-specific reports every six months. In January, a new five-tier system was released for the first time by the SRTR and UF Health’s kidney transplant program was one of the top programs in the country at tier five. The standard evaluation system by the SRTR looks only at actual compared to expected patient and graft survival. In those traditional measurements, UF Health’s kidney program was numerically better, but statistically as expected.
“Close care of patients as they both await transplant and after transplant is paramount for good patient outcomes. The transplant surgical event also needs to be as complication-free as possible to give both the patients and their new organs the best start possible,” said Kenneth Andreoni, M.D., an associate professor and chief of the division of transplantation surgery at the UF College of Medicine. Andreoni oversees the division’s kidney, liver and pancreas transplantation program.
“We have emphasized very close yearly examination of patients on the waiting list for transplant. These patients have many medical diseases and need to be ready at any moment for a transplant offer,” Andreoni said. “We also stress close follow-up after surgery to help with patient medication understanding and compliance.”
Over the last five years, UF Health’s solid organ transplant programs — including kidney — have aggressively undergone quality improvement, noted Andreoni and Karl Womer, M.D., the medical director of UF’s adult kidney transplant program.
Among the improvements is the establishment of a solid organ transplant core quality committee that oversees each of UF’s individual organ specific committees, or OSCs.
“Our kidney and pancreas OSC is composed of both adult and pediatric transplant specialists and truly encompasses the wide range of health care professionals involved in this complex patient care service,” Andreoni said.
Strong outcomes reflect a multidisciplinary approach to patient care that draws on the combined experience of transplant physicians, transplant surgeons, nurse coordinators, transplant assistants, social workers, financial counselors, transplant pharmacists, immunogeneticists, anesthesiologists, intensivists and psychologists, noted Womer, who is also a professor in the UF College of Medicine’s division of nephrology, hypertension and renal transplantation.
“This multidisciplinary approach ensures that several team members with complementary skills work together to provide the best care possible for our patients. Furthermore, other centers may follow a kidney transplant patient only for a number of months. At UF Health, we follow our patients for life,” Womer said.
UF Health just celebrated its 50th anniversary of kidney transplantation, having established its transplant program in 1966 as the first program in Florida. Since then, surgeons at the UF Health Shands Transplant Center have performed more than 4,500 kidney transplants, including 800 from living donors.
SRTR introduced its five-tier outcome assessments in December 2016. In February, however, the Human Resources and Services Administration requested that the agency revert to its original three-tier system to allow time for feedback and comments.
“In response to feedback received from members of the transplant community regarding the lack of adequate time to review the new five-tier rating system prior to implementation, HRSA requested that SRTR transfer the 5-tier rating to an alternate, publicly available beta site to undergo further review and identification of areas for improvement,” SRTR stated.