An average of 13 people die each day in the United States while waiting for a kidney transplant.
However, the potential to save these individuals is possible through better utilization of donated organs and more living kidney donors. Silas Norman, MD., Director of the University of Michigan Health Associates Transplant Center.
To that end, UM Health will now participate in one of the nation’s most advanced programs, the Expanded Organ Transplant Access Model, to ensure its own ongoing success. Kidney transplant program.
Expanded Organ Transplant Access is a new model from the Centers for Medicare and Medicaid Services Innovation designed to increase kidney transplants by encouraging transplant centers to perform more transplants, improve coordination and efficiency of care, and create a more patient-centered focus on care delivery.
Here, Norman shares his thoughts on the model and its implications for the future of kidney transplantation.
why is Increased organ transplant access Is the model important for transplant recipients?
Norman: We know there are more people waiting for kidney transplants than we have the organs we have.
People on the waiting list often wait three to six years for a transplant.
For many, the waiting period is too long.
Improving transplant access through IOTA could be lifesaving for these individuals.
Based on other recent CMS models designed to optimize dialysis and transplant care, the IOTA model focuses on five areas to improve transplant care:
• Maximizing the use of deceased donor kidneys
Improved access to living kidney donation
• Addressing barriers to transplant access
• Improving coordination of care
• Improving quality of care across the continuum of transplant care
IOTA is structured so that half of the nation’s donor service areas, including Michigan, will participate in the IOTA model.
UM Health has worked with organ procurement and transplant networks to increase organ transplants. How will this model advance this effort?
Norman: Despite the number of people waiting for an organ transplant, many potentially transplantable organs are discarded each year.
The IOTA model helps address this issue by encouraging transplant centers to accept more organs and identifying and removing barriers to successful transplants.
At UM Health, we are working to educate patients about transplant options in time, thinking creatively about how we support patients before and after transplant, and changing our transplant medicine approach to best support more marginal donor kidneys to function successfully.
How will this effort to increase organ transplantation be accomplished?
Norman: First, we are working to ensure that as many patients on our waiting list as possible are ready for transplant.
Specifically, ensuring that all tests are up to date and that people are physically and mentally prepared for their transplant offer.
We are modifying the drugs we use to be more effective.
We have ongoing educational offerings as well as new partnerships to encourage and support living kidney donation.
We work closely with our patients’ local doctors to coordinate care and provide care locally whenever possible.
How will your role help this effort move forward?
Norman: I work closely with our nursing, surgical and administrative partners to continually look at how we can serve our patients more effectively.
My work focuses on the ambulatory or outpatient side of our transplant work across each of our organ transplant programs: kidney, liver, lung and heart. We recognize the need to improve access and be patient-centred, providing care close to where people live and work.
Not only is it more convenient for patients, but with local care, the patient is more likely to be able to participate in the support network, thus saving patients transportation costs and lost work time while driving to UM Health in Ann Arbor.
With this in mind, we are expanding and strengthening our outreach clinics.
We have clinics spread across the state, most recently in Traverse City.
In addition to pre-transplant assessment, we are providing some post-transplant care locally and try to do as many necessary tests locally as possible.
Some of our clinics will offer access to multiple transplant organs, for example clinics where both kidney and liver transplant providers see patients, further improving coordination of care.
How will the increase in organ transplants benefit you patients?
Norman: There are currently more than 90,000 people nationally waiting for a kidney transplant, including 2,300 in Michigan.
By contrast, only 27,000 kidneys were transplanted last year.
A record achievement, but far less than needed.
If we can make better use of donated organs, we have the potential to successfully transplant people and intervene in end-stage kidney disease.
Does this optimization of organ use extend to living donors?
Norman: absolutely We know that a kidney from a living donor is the best way for someone to receive a kidney transplant.
The quality is often better, and we can transplant people more quickly, when they are at their healthiest, using living donor kidneys that last longer.
Currently there are barriers to living donation.
The first barrier is lack of awareness.
We have classes for patients and potential interested donors to educate themselves about the process and safety of being a living kidney donor.
There may be barriers, such as lost work time for donor candidates and ease of navigating the transplant system.
There are systems in place to help donors offset costs and we are working as a team to improve the efficiency of living donation.
An important new partnership is “Give to Live,” an organization that works directly with our patients to identify potential donor candidates and help them navigate the donor process.
What else should referring physicians and their patients know about the UM Health Kidney Transplant Program?
Norman: It’s an exciting time to replace.
UM Health Transplant Center is focused on getting our patients the right kidney at the right time.
We encourage physicians and their patients with advanced chronic kidney disease or on dialysis to contact us so that we can begin the transplant process.
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Previously published Also at michiganmedicine.org Creative Commons License
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