Division of Transplant Surgery

BETTER ACCESS IMPROVES PATIENT CARE AND REDUCES DISPARITIES

Transplant patients – many of whom are in end-stageorgan failure – no longer need to travel to Charlestonfor evaluation and post-transplant care. Our expandedTelehealth services and outpatient satellite clinic locationsthroughout the state now can accommodate mosttransplant patients for both pre- and post- transplantcare. The clinics are staffed by our advanced practiceproviders who are embedded in the community as wellas our clinical faculty. We also have strong relationshipswith our community partners who can perform the pretransplant With clinics in the upstate, the midlands, Florence,Myrtle Beach and Murrell’s Inlet, our local high-qualityaccess helps provide patients a better quality of life.For patients where local clinics are not available, wehave expanded our Telehealth services which affordstremendous benefits for patients undergoing atransplant evaluation so when the in-person visit occurs,it is a purposeful and efficient process. Now patientswho would otherwise have barriers to access, includingunderserved populations, have a more seamless andefficient transplant experience.process.

 

FIRST IN STATE: EXPANDING TREATMENT OPTIONS FORCHOLANGIOCARCINOMA PATIENTS

Liver transplant surgeon Jared White, M.D. collaborated with a multidisciplinary team of at the Hollings Cancer Center toperform the first liver transplant for unresectable cholangiocarcinoma in the state of South Carolina. Cholangiocarcinomais a rare, malignant tumor of the biliary system that can cause jaundice and liver dysfunction. Treatment optionsare often limited with low rates for surgical cure and a high rate for morbidity and mortality. Using a combination ofneoadjuvant chemoradiation therapy followed by liver transplantation, our highly specialized multi-disciplinary team canoffer an opportunity for a curative treatment in well-selected patients with unresectablecholangiocarcinoma.

VIRTUAL CROSSMATCHING IMPROVES QUALITYOF LIFE FOR KIDNEY TRANSPLANT PATIENTS

Virtual antibody crossmatching is a safe and efficient way of selecting kidneytransplant recipients. Two years after implementing the process, the MedicalUniversity of South Carolina division of transplant surgery concluded that thetechnique was just as accurate and sensitive as physical crossmatch, the currentgold standard, and much quicker. Virtual crossmatching reduced the timekidneys were kept on ice while awaiting identification of a suitable recipient,improved scheduling for surgeons and operating room staff, and alleviatedemotional and logistical stress on patients who were called to the hospital onlyto be sent home hours later after a more suitable recipient was identified.

Transplant surgeon Vinayak Rohan, M.D. is the lead author and DavidTaber, Pharm. D. is senior author, in collaboration with Omar Moussa, Ph.D.on the study of the virtual crossmatching process and its effects on clinicaland surgical practice outcomes that appeared in the Journal of the AmericanCollege of Surgeons. The study is a before-and-after comparison of patientoutcomes two years after the transplant surgery team implemented virtualcrossmatching. Standard measures of clinical quality were the same in bothgroups. The incidence of delayed graft function was 19% before and 17%after implementation; graft failure within a year was 4% before and 3% after;mortality within a year was 2% before and 1% after. The study also found thetime a donated organ is kept on ice for long-distance donor organs decreasedby 2.4 hours, and delayed graft function declined by 26%. Importantly, despite ahighly sensitized population, there were no hyperacute rejections. Additionally,the ability to schedule the operation even before the organ arrives provides animprovement to the surgeons' quality of life.