Drs. Robert Stratta, Alan Farney, Jeffrey Rogers, and Giuseppe Orlando are fellowship trained multi-organ abdominal transplant surgeons specializing in kidney and pancreas transplantation, dialysis access, and general surgery in patients with renal failure. Drs. Amber Reeves-Daniel and Amudha Palanisamy are fellowship-trained nephrologists specializing in transplantation medicine. We are actively involved in managing post-operative immunosuppression, complex infectious disease, critical care, primary care, and long-term management of transplant recipients. We provide transplant care to the full spectrum of patients with end stage renal disease, from pediatric to geriatric candidates. The four surgeons collectively have more than 60 years of experience in the field of solid organ transplantation.
Comprehensive pre-transplant evaluation and post-transplant care are provided 5 days a week at the outpatient transplant clinic by our highly experienced multidisciplinary team consisting of transplant surgeons, nephrologists, advanced practice providers, nurse coordinators, pharmacists, nurses, social workers, financial and data coordinators, and ancillary staff. The clinic is open Monday through Friday, can accommodate unscheduled visits, and can perform laboratory testing/imaging studies and office procedures/treatments within the confines of the clinic building.
The Wake Forest Baptist Health (WFBH) Abdominal Organ Transplant Program performs 160-180 transplants annually (about one every other day) and is ranked amongst the top 30 most active kidney and pancreas transplant programs nationally. Within the Scientific Registry of Transplant Recipients (SRTR) database (a national database that compares our center with regional and national data), our center has higher than expected patient and graft survival rates based on our patient mix, lower than expected waiting times and waiting list mortality, higher rates of organ acceptance and imports, higher rates of transplantation (in nearly all age groups, but particularly in the elderly), greater utilization of expanded criteria donor kidneys, and improved waiting list turnover compared to other programs in our region. A recent statewide study showed that waiting times for transplantation at our center are 50% lower (median 3 years) than 3 of the 4 other transplant centers in the state (median 6 years) and similar to the remaining center.
As of July 1, 2017, 3218 kidney transplants and 246 pancreas transplants have been performed at WFBH in the 47 year history of the program. A total of 2051 transplants have been performed during the past 12 years, which is an average of 171 transplants annually. In spite of the introduction of a new national kidney allocation system on 12/4/14, we have maintained our volumes and outcomes although we are transplanting a more complex recipient population. For example, recent changes in kidney allocation have facilitated the successful transplantation of a number of highly sensitized patients who previously had been waiting for many years with few or no kidney offers. Moreover, with kidney waiting time now linked to dialysis duration in the new allocation system, access to kidney transplantation is markedly improved for those patients who may be “running out of time” and in desperate need of a potentially life-extending kidney transplant. WFBH is the largest kidney and pancreas transplant center in the state of NC and one of the largest centers in United Network for Organ Sharing (UNOS) Region 11 (that includes the states of NC, SC, KY, TN, and VA). Since 1999, we have more people living with a functioning kidney transplant than any other transplant center in NC.
The program has a special interest in transplantation of “high risk” candidates, including patients with coronary artery disease, peripheral artery disease, diabetes, morbid obesity, and adequately controlled chronic viral infections such as HIV and hepatitis C. For patients with diabetes, all types of pancreas transplants are offered. Desensitization protocols and paired kidney exchanges are available for highly sensitized patients and for patients with crossmatch or blood type incompatible living donors. In addition, we have an established track record in successfully transplanting patients who have been refused at other centers as well as patients who have had one or more previous transplant.
The pre-transplant "cycle" time (from education class to placement on the wait list) is approximately 6 months. For patients with potential living donors, a "fast track" or expedited pre-transplant evaluation can be performed, particularly if the patient is either on dialysis or dialysis imminent. Novel immuno-suppressive strategies are utilized, with an emphasis on steroid sparing protocols. Over 70% of new transplant patients are steroid-free when they are discharged from the hospital. With the implementation of new inpatient critical pathways, the length of inpatient stay immediately following transplantation has been reduced to 5 days or less in most cases.
For pre-transplant appointments, please call 336-713-5661.