Living Donor Kidney Transplant

April 15, 2012

Margaret LeidTransplant Community Liaison

Penn Transplant Institutemargaret.leid@uphs.upenn.edu

2

Greater Philadelphia Region Kidney Transplant Centers Deceased & Living Donor Transplants: Volume*

* Scientific Registry of Transplant Patients, January 2012.Time period 7/1/2010 – 6/30/2011. www.srtr.org

3

Penn Transplant Institute3-Year Patient Survival

Penn Transplant InstituteBest 3-Year Graft Survival in Region

Penn Transplant Institute Highest Volume Center in the Region

SRTR Data 1/2012. For patients transplanted

between 1/1/2006 and 6/30/2008

4

Penn Transplant Institute – Kidney Transplant Program

EXPERIENCEFirst kidney transplant

1966

VOLUMEHighest volume in

Philadelphia Region

OUTCOMESBest 3-year graft survival rates in

Philadelphia region*

LIVING DONOR TEAMOne of country’s most experienced teams. Most living kidney donors in region*

GUEST HOUSEFor transplant

patients and their families traveling

more than 50 miles

EVAL CLINIC YARDLEY, PA

Reduces travel time by car from NYC by

one hour each direction

ACCESSIBLEBy Train

Amtrak, NJ Transit By Bus

Greyhound Megabus, Bolt Bus

LOCATIONHistoric University of

Pennsylvania Campus located in

shopping/dining University City District

*Based on January 2012 SRTR data

5

Clyde F. Barker Penn Transplant HouseNEW GUESTHOUSE

Built in June 2011For Penn transplant patients and families traveling more

than 50 miles

SUPPORT THROUGH ALL PHASES OF CARE

EvaluationSurgery

Follow-up

CONVENIENT LOCATION

Five blocks from PennOn Septa bus line

INSURANCE COVERAGE

Considered part of travel expense for transplant

evaluation and follow-up.Check with insurance company

KIDNEY TRANSPLANT SUPPORT GROUPS

Second Sunday of each month. Pre and post transplant patients

and their familiesLight refreshments provided

LONG TERM STAYSBeautiful common kitchen area

with storage for each family. Common living and dining area

for connection with other transplant patients and families.

For Reservations and Additional Information: 215-662-4540

6

Questions to Run On

Why does a kidney from a living donor sometimes last twice as long as a kidney from a deceased donor?

How do I know it is safe for my friends or family to donate a kidney to me?

How does someone interested in learning about donating a kidney get information before committing to the surgery?

What are the health requirements for someone thinking about donating a kidney?

7

How Do Kidneys Become Available?

DONOR HOSPITAL

Living Donors Do Not Need to Be in Your

Family

OR

Living Kidney Donors4 to 6 Year Wait

Deceased Donor Kidneys

UNITED NETWORK OF ORGAN SHARING (UNOS)

8

(UNITED NETWORK FOR ORGAN SHARING)

Government contract to oversee the national

system for U.S. organ procurement an transplantation

One Central Database

ACUTE CARE HOSPITALSACUTE CARE HOSPITALS

Work with OPOs to coordinate the Work with OPOs to coordinate the organ donation processorgan donation process

Transplant Waiting List:

Updated Every Time A Family Says Yes to Donation and Every Time a

Patient is Added to the List

Where do deceased donor kidneys come from?

TRANSPLANT CENTERS

List patients for transplant Penn is 1 of 256 transplant

centers in the U.S.

Donor Data Sent to UNOS

Family Says Yes to

Donation

Recipient data sent to UNOS

computer system

9

112,637

U.S.TRANSPLANT WAITING LIST ALL ORGANS 90,621

KIDNEY = 80%

WAITING

GIFT OF LIFE DONOR PROGRAMDONATION YEAR 2009-2010

780 KIDNEY

TRANSPLANTS

OPTN DATA 1/20/2012

http://optn.transplant.hrsa.gov

Our Region5,335

AVERAGE WAITING TIME

3–5 YEARS

(BASED ON BLOOD TYPE)

10

91,425 people in U.S. waiting for kidney

An average of 16,000 people receive kidney transplants per year

Gallup Poll of Americans

93%Would Donate Their Loved One’s Organs If They Knew Their Wishes Ahead of Time

Donor DesignationPennsylvania

45.2% Philadelphia County

30%

11

12

How Many of Your Patients

Understand:

Dialysis shortens life expectancy compared to transplant.

The less time on dialysis before transplant, the better the kidney will function and

the longer it will last.

13

Optimum Strategies to Minimize Time On Dialysis

Living Donors

Consider Kidneys from Expanded Criteria Donors

(ECD)

14

Summary of Options

Own healthy kidneys

Living donor kidney

Standard criteria kidney

Expanded criteria kidney

Dialysis

Most life years

Fewest life years

15

Why does a kidney from a living donor sometimes last twice as long as a kidney from

a deceased donor? Kidney not impacted by brain death.

The time the kidney is without blood flow is dramatically reduced.

Living kidney donors are healthier than the average person.

Only very healthy people are accepted at Penn to be living kidney donors.

First living donor transplant at Penn more than 40 years ago. Donor and recipient still doing well.

16

Benefits of Living Kidney Donor Transplantation

Kidney lasts longer – improved quality Avoid dialysis completely or shorten time on dialysis

• Before complications develop Improved patient survival Avoid 4-6 year wait for deceased donor kidney Time of transplant operation is made at convenient

time for donor and recipient Minimal delayed organ function Medicines post-transplant may be less aggressive

Who can be a living donor? Family member

Friend Stranger

17

18

Living Donor Evaluation ProcessExtensive and Thorough

DONOR EDUCATION

SESSION

MULTI-DISCIPLINARY EVALUATION

NEPHROLOGY EVALUATION

SURGICALEVALUATION

DONOR SELECTION

COMMITTEE REVIEW

19

Interested in Living Kidney Donation?Steps for Listed Patients

Complete all testing and attain status 1 on the transplant waiting list.

Share with your family and friends your experiences with chronic kidney disease and dialysis.

1. Invite interested potential donors to complete the Living Kidney Donation Referral Form.

2. Encourage friends and family members to support organ donation awareness initiatives through Gift of Life.

Steps for Potential Donors

1. Submit request for private preliminary consultation with the Living Kidney Donor team.

2. Learn about the living kidney donor process through the evaluation process

3. Talk with the team about concerns and questions.

4. Decide if this is the right option for you at this time.

20

What Are the Top 5 Criteria to be a Living Kidney Donor?

Free from diabetes, cancer, kidney disease, heart disease and

substantial high blood pressure.Physically fit - Body Mass Index

(BMI) <30

Between 21 and 60 years old

Stability in life maintenance issues.Good general health

21

Paired Kidney Exchange

22

How to Find a Living Donor

Share your story about dialysis and needing a kidney transplant.

Learn about living donor kidney transplant

- Volunteer organizations- Religious groups- Friends and family: consider a spokesperson

Penn Transplant Website http://www.pennmedicine.org/transplant/

American Society of Transplant Surgeons (ASTS) http://www.a-s-t.org/

National Kidney Foundation - http://www.kidney.org/

American Society of Transplantation http://www.asts.org/ResearchEducation/PatientEducation.aspx

23

How does someone interested in learning about donating a kidney get information

before committing to the surgery?

24

Patient Education

Lobby Days

One to One Sessions

Intro to Kidney Transplant

Multiple Listing

Dialysis Unit Staff

Inservices/Luncheons

Transplant Eval Process

Organ Donation Protocols

Understanding SRTR Data

PENN KIDNEY TRANSPLANT : PATIENT & STAFF EDUCATION SERVICES

25

26