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The most active living donor liver transplant programs

Improvement

The most active living donor liver transplant programs

University Health System Transplant Center San Antonio saw a more than six-fold annual increase in their volume of living donor liver transplants between 2017 and 2019.

Illustration of a hand gifting a liver

Last year 524 people across the country provided the lifesaving gift of organ donation by serving as living liver donors — a 30 percent increase over 2018 and the highest number since 2001, according to the Organ Procurement and Transplantation Network.

Although 61 transplant hospitals across the country have performed at least one living donor liver transplant in the past two years, most of the surgeries cluster in a cohort of hospitals with very active living donor transplant programs. Five hospitals in particular each performed at least two dozen of the transplants in 2019.

University Health System Transplant Center San Antonio

San Antonio

Year of first living donor liver transplant: 1999

Logo University Health System

6 in 2017

30 in 2018

38 in 2019

112 to date

USC Transplant Institute, Keck Medicine of USC

Los Angeles

Year of first living donor liver transplant: 1999

Logo Keck Medicine of USC

13 in 2017

6 in 2018

23 in 2019

227 to date

New York-Presbyterian/

Columbia University Irving Medical Center

New York

Year of first living donor liver transplant: 1998

Logo New York Presbyterian

23 in 2017

15 in 2018

24 in 2019

386 to date

Cleveland Clinic

Cleveland

Year of first living donor liver transplant: 1999

Cleveland Clinic logo

8 in 2017

19 in 2018

26 in 2019

168 to date

University of Pittsburgh Medical Center

Pittsburgh

Year of first living donor liver transplant: 1999

UPMC logo

60 in 2017

56 in 2018

76 in 2019

488 to date

* Based on OPTN data as of Jan. 16, 2020

Sharing effective practices

University Health System Transplant Center, in partnership with UT Health San Antonio, is among the five high-volume hospitals. As part of the center’s academic and research community, the hospital is home to the only living liver program in south and central Texas. Health care providers there performed the second-highest volume of living donor liver transplants in the country in 2019.

In describing their success Claudia Grimmer, who serves as assistant director of live liver donation at the health system, stressed that it is the result of five years of work and collaboration to grow the program.

Grimmer said the most significant changes include:

  • Perfecting the donor evaluation process and scheduling those donors who meet the criteria for surgery within a month: “We’re considering the recipient’s health. The hope is to get them transplanted before they become too ill to survive transplantation or before the onset of life-threatening complications of their disease.”
  • Evaluating three-to-five donors for one recipient simultaneously in order to create a bigger pool and streamline processes: “If a donor is deemed not a candidate, then we’re not starting all over again from scratch.”
  • Innovative approaches, such as paired liver donation: “We don’t want to turn a donor away because they are not compatible.”
  • Encouraging their patients to share their story on social media and recruit potential donors: “People are more educated about living donation now. Especially with younger altruistic donors, people are educating themselves before even coming forward.”
  • Moving past their own misconception that the area’s majority Hispanic population was not accepting of becoming living donors. “What we thought was a barrier is truly not.”

 

University Health System Transplant Center executive director Patricia Jones says their program has transformed because of the combination of Grimmer’s persistence and the dedication of associate professor of surgery at UT Health San Antonio Tarunjeet Klair, M.D., who joined the hospital three years ago from New York-Presbyterian/Columbia University Irving Medical Center. Calling Klair a physician champion, Jones said his support and direction made a tremendous difference in University Health System Transplant Center’s living donor liver transplant numbers.

2019 was a record-shattering year overall for living donation — the 7,397 total living donor transplants in 2019 far exceeded the previous record of 6,992 set in 2004. In total, health care teams across the country performed 39,718 transplants with organs from both deceased and living donors. This marks an 8.7 percent increase over 2018 and a seventh consecutive annual record. Read more about how the organ donation and transplant community helped save more lives than ever before in 2019.

Claudia Grimmer

“People are more educated about living donation now. Especially with younger altruistic donors, people are educating themselves before even coming forward.”

Claudia Grimmer

Assistant director of live liver donation at University Health System Transplant Center San Antonio

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