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UMC saving more lives by focusing on kidney transplants

Each year, 7,000 people in the U.S. die of kidney disease while waiting for a transplant. This is a particularly important issue in Mississippi, which has one of the highest rates of diabetes and kidney failure in the nation.

But this year, more lives are being saved due to a major increase in kidney transplants at the University of Mississippi Medical Center (UMC) in Jackson. The center recently completed its 50th kidney transplantation this year, five times the number of transplants performed in 2006.

Dr. Henry Barber, professor of surgery, has performed 13 transplants this year. The rest of the transplant operations have been performed by Dr. Alan Hawxby, chief of transplantation, who joined UMC in March to concentrate solely on kidney transplants.

“Here at the university, the biggest change has been more institutional commitment from the hospital and medical school to put more emphasis on transplantation,” Hawxby says. “When they hired me, it was with the understanding that is pretty much all I would be doing. I was made responsible for building the program where it ought to be. In the past, transplant surgeons had to do things outside of transplant such as general surgery and emergency surgery. Transplant is all I do. It is my goal to build this program to as healthy a status as it can be, do as many transplants as possible and get the best possible results.”

Dr. William Ferniany, associate vice chancellor for health systems and University Hospitals and Clinics CEO, says UMC is committed to developing transplant services to serve the citizens of Mississippi.

“This 50th kidney transplant is a physical sign of our commitment and the commitment of our physicians and staff to that goal,” Ferniany says.

Live longer, quality of life

Patients live longer and have better quality of life after transplants. Patients on dialysis have to spend so much time receiving treatment that it is difficult to hold a job or make other commitments.

Transplantation has been shown to be more cost effective than dialysis.

“It has been estimated that the cost savings to the healthcare system for transplants compared to dialysis for a living donor transplant is about $90,000 over the lifespan of one kidney,” Hawxby says. “People don’t have to go to dialysis three time a week, so it is easier to go to school or hold jobs. Patients live longer after a transplant than on dialysis. That has been shown in every major demographic, all ages, every race and both sexes.”

Approximately 90% of the patients on the waiting list for transplants are African American, which reflects who is more likely to get renal failure here in the state.

Currently, more than 2,000 Mississippians are on dialysis or waiting for a kidney transplant.

Advances have been made in recent years improving the outcome for kidney transplantation. The past 10 years have seen major improvements with anti-rejection drugs.

“In the older days, successful transplantation depended on a good degree of matching, not just matching blood groups but tissue types as well,” Hawxby says. “Now we don’t have to worry as much about the degree of matching required for transplantation. And so we can use less well-matched donors particularly with living donors. We don’t have to require that the donor be a family member. It can be a friend, a colleague, a spouse or a church member.

“The other big breakthrough we have just started doing is laparoscopic living kidney donation. That is done with laparoscopic techniques just as gall bladders are removed these days. Instead of a large incision, we can use three smaller incisions and small incision on the flank that makes it less invasive, much less painful for donor. We have had donors get out of the hospital in two and three days and go back to work in a couple of weeks. There is much less of a disincentive to donate. We just did our first one here recently and the patient did great.”

The person receiving the kidney gets standard surgery.

More donors

Many more lives could be saved if more people would consider becoming organ donors. Right now many people die while waiting for a kidney.

“If we had enough donors in Mississippi, we wouldn’t have to worry about death on the waiting list,” Hawxby said. “It is just a desperate situation for some of these families.”

Mississippi ranks third in the country in the number of patients with kidney failure. Contributing factors can include obesity and high blood pressure. Hawxby said to prevent renal failure, there needs to be a widespread attack on the reasons for high blood pressure. He advocates screening people as early as high school or before. Better education combined with wellness programs and surveillance could result in significant improvements.

Future plans for UMC’s transplant program include developing a vigorous living donor program for kidney transplantation, increasing transplant research and increasing the number of heart transplants.

Contact MBJ contributing writer Becky Gillette at bgillette@bellsouth.net.


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