WINSTON-SALEM, N.C. – Wake Forest University Baptist Medical Center was one of the 50 most active kidney transplant centers in the country in 2004, according to the November issue of Nephrology News and Issues. The center performed 115 transplants, making it the 41st most active center in the United States.
The magazine compiled the list based on transplant data from the Centers of Medicare and Medicaid Services.
"We have more than doubled our number of kidney transplants since 2001. More importantly, we continue to achieve excellent results while reducing waiting times,” said Robert Stratta, M.D., director of transplantation services.
He said one key to success is using newer methods to match donated kidneys to recipients. In the past, kidneys were matched exclusively by blood and tissue type. Newer approaches to matching have come about as a result of a system implemented by the United Network for Organ Sharing (UNOS) in October 2002 for allocating older donor kidneys that were once discarded as unsuitable for transplantation.
These include kidneys from deceased donors over age 60 or those over age 50 with health conditions such as high blood pressure or elevated levels of a protein called creatinine. Levels of creatinine, which is produced by muscle, are used to determine kidney function.
Using kidneys from these donors, which UNOS calls expanded criteria donors (ECDs), permits more patients to benefit from transplantation, Stratta said, but requires careful matching. Using ECD kidneys, Wake Forest Baptist is currently on a pace to perform more than 140 kidney transplants in 2006.
“We are encouraged by our success using organs from deceased donors that would ordinarily have been discarded,” said Stratta. “Even organs donated after cardiac death can be suitable in some cases, which has been taboo in the past. By appropriate donor and recipient profiling, we are finding out that patients who have received ECD kidneys are doing as well as patients receiving kidneys from younger donors even more than three years following the transplant.”
Stratta and colleagues continue to investigate the best way to match donor kidneys with recipients and are frequently invited to present their results at national professional meetings.
“The shortage of donated organs is a national crisis, with people on the waiting list dying every day,” said Stratta. “This mandates an ongoing reappraisal of the limits of donor organ acceptability.”
More than 400 people are on the waiting list at Wake Forest Baptist for kidney transplants. As of late November, the center has performed over 120 kidney transplants in 2005.
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