From the moment a patient is first considered as a possible candidate for organ transplantation, UCSF sets in motion a model for care that is recognized as the national standard. Founded in the 1960s, the UCSF Transplant Service is one of the oldest and most respected programs in the transplant field.
Neil Jones, recently recovering from heart surgery, has a clinic visit with Dana McGlothlin, MD, a cardiologist specializing in echocardiography and professor of medicine at UCSF.
All organ transplantation at UCSF is carried out under the auspices of the Department of Surgery in two areas of specialty: abdominal (kidney, liver, pancreas, intestine, islet cell) and cardiothoracic (heart, lung). Solid organ transplant is the focus of the department, but as transplantation science evolves, UCSF specialists are pioneering new approaches such as transplanting islet cells from the pancreas — instead of the full organ — to treat type 1 diabetes.
Distinctive UCSF Approach
UCSF's approach to transplantation care is distinguished in three significant ways:
- Team approach: A team of specialists representing several disciplines assesses candidates for transplant and determines their eligibility and urgency of need for organs, a crucial process in view of the profound shortage of all organs and long waiting lists. Individuals who are potential living donors — for kidney and liver transplants — receive the same attentive care from a team of experts who provide extensive medical evaluation, counseling and guidance while donation is being considered.
- Comprehensive care: Each patient receives comprehensive care from a team of experts who represent medical disciplines as well as support services, including transplant surgeons, medical specialists (such as nephrologists for kidney disease, hepatologists for liver disease and gastroenterologists for intestinal disorders), nurse specialists, anesthesiologists, social workers, family counselors, nutritionists and financial counselors. The team is committed to meeting each individual’s needs, and all team members are involved in developing an overall plan for the patient.
- Continuum of care: The patient’s designated team provides a continuum of care, following the patient from pre-transplant through post-transplant. The team focuses on the health and comfort of the patient and meets daily for as long as necessary.
This UCSF standard of care is the same for adults and children. Children who previously had little hope of survival in the event of organ failure now are thriving as healthy adults with transplanted organs. “Patients are our highest priority, and I think we do patient care better than anyone else,” says John Roberts, MD, chief of the UCSF Transplant Service and a transplant surgeon. “Our multidisciplinary teams provide excellence across departments to offer coordinated patient care that is not seen in many institutions.”
“Our division is deeply committed to offering the best clinical care, the most productive and innovative research programs and an outstanding educational program that trains future leaders in the field of transplantation.”
One of the measures of transplant program quality is survival rates, and UCSF consistently exceeds the national averages reported by the Scientific Registry of Transplant Recipients.
UCSF routinely treats some of the sickest transplant patients or those with extensive complications, making its outcomes particularly significant, says Nancy Ascher, MD, PhD, chair of the UCSF Department of Surgery and a transplant surgeon. “Our survival rates are not just good; they are excellent. This shows how hard we try to bring success to seriously ill patients.”
Volume is important to transplant program success, with a higher number of procedures translating into greater experience by the medical team and greater opportunity to improve patient care and outcomes, Ascher emphasizes.
UCSF is one of the busiest transplant centers in the country, averaging 500 solid organ procedures a year. Since performing its first organ transplant in 1964 — a kidney procedure — UCSF has performed organ or islet cell transplant procedures in more than 11,000 patients. The volume of UCSF programs includes:
John P. Roberts, MD, FACS
- Heart: The UCSF Heart Transplant Program has performed more than 250 procedures since it was launched in 1989. The program is designated as a Center of Excellence by Blue Cross and Blue Shield insurance plans of California.
- Intestinal: UCSF is one of the few transplant programs in the country that performs intestinal transplants. This procedure is a last-resort treatment for patients with intestinal failure, offering a long-term treatment for patients to continue to digest food and get life-sustaining nutrients.
- Islet cell: About eight UCSF patients a year are undergoing pancreatic islet cell transplants to treat type 1 diabetes, and UCSF teams are participating in major clinical trials of this procedure.
- Kidney: Each year, the transplant team evaluates about 1,200 patients and performs more than 300 kidney transplants. UCSF has performed more than 8,300 kidney transplant procedures since the program was established – more than any institution in the world. UCSF is the fifth-largest center for living-donor kidney transplants in the country.
- Liver: The UCSF Liver Transplant Program, designated a Center of Excellence by the US Department of Health and Human Services, does more liver transplants than any other hospital in Northern California. The program has performed more than 2,300 liver transplant procedures for adults and children since it began in 1988.
- Lung: UCSF has performed more than 340 lung transplants since 1991, when this program was established. The Lung Transplant Program is in the top 10 percent in the world for volume of procedures performed and is known for successful transplants in very ill patients.
- Pancreas: In the past two years, UCSF transplant specialists have performed more than 60 pancreas transplants — making UCSF one of the busiest centers in the country for this procedure. UCSF is a leader in both pancreas and pancreas-kidney transplants in patients with diabetes.
- Pediatric: Pediatric transplant patients also benefit from the volume of procedures and the experience of UCSF transplant teams. UCSF Benioff Children’s Hospital is home to pediatric liver and kidney transplant programs that are among the oldest and most active children’s transplant centers in the country. More than 500 children have undergone kidney transplants since UCSF founded its transplant program in the 1960s, and 200 children have received donor livers since 1988, when UCSF performed its first pediatric liver transplant.
- The UCSF Benioff Children’s Hospital Pediatric Intestinal Rehabilitation and Transplantation Program is one of the few in the country offering intestinal transplants for children.
Part of a Vital Network
As a major transplant center, UCSF is a member of the United Network for Organ Sharing, a nonprofit organization under contract with the federal government to manage the nation’s organ transplant system. UCSF is also a founding member of the California Transplant Donor Network, an independent regional organization that maintains relationships with more than 150 hospitals in Northern California and Northern Nevada to identify potential donors, distribute donor organs, and provide education about organ donation and transplantation.
Among UCSF’s special services for kidney transplant patients is the Connie Frank Transplant Center, a renovated wing on the seventh floor of the Ambulatory Care Center on the Parnassus Heights campus. Completed in June 2010, the center is designed specifically as a warm, comfortable space for pre- and post-kidney transplant patients. It is expected that the center will host about 3,000 patients a year.