Transition of Kaiser Kidney Transplant Patients to UCSF Begins
by Jennifer O'Brien
UCSF Medical Center has begun the process of accepting some 1,500 Kaiser Permanente patients into its Kidney Transplant Service, in the wake of Kaiser's May 12, 2006, announcement that it would indefinitely suspend its own program.
An additional 300 to 500 Kaiser patients will be transferred into UC Davis Medical Center's transplant service.
The transition, being carried out in close collaboration with Kaiser and the State of California Department of Managed Health Care, which is overseeing Kaiser's transition, is expected to take until mid-October.
"We're very pleased that the transition is underway," says Mark Laret, CEO of UCSF Medical Center. "These first steps mark an important juncture in a process that will be carried out over the next several months.
"The close working relationship between UCSF, Kaiser and the Department of Managed Health Care during the last two weeks has allowed us to establish a plan aimed at ensuring that the transition is as safe, quick and smooth as possible for the patients involved."
UCSF Adding Resources
To accommodate the influx of patients, the UCSF Kidney Transplant Service, one of the premier transplant programs in the world, is expanding its physician and clinical resources, and significantly increasing nursing and administrative support staff. "We will maintain our commitment to the patients currently on our waiting list as we add the Kaiser patients," says John Roberts, MD, FACS, chief of the UCSF Division of Transplant Services. On Wednesday, May 31, 2006, the team received the medical records of the first group of Kaiser patients designated for the transition - seven patients awaiting new kidneys from living donors - and has begun the process of reviewing the records and scheduling introductory medical evaluation appointments. "The transition presents a challenge, but our team is committed to the process," says Roberts. UCSF Transplant Success
UCSF has performed more kidney transplants than any other institution in the world - about 7,500 since 1964 - and is the second-largest center for living-donor kidney transplants in the United States. Each year, the transplant team evaluates approximately 1,000 new patients for kidney transplantation and performs more than 250 kidney transplants. Its transplant success rate is one of the highest of all California programs, and the pediatric kidney transplant program is one of the largest in the United States. The UCSF service is distinguished for its success in treating the most challenging types of cases, and has "demonstrated its ability to support patients through the complex process leading up to a transplant and through the surgical and postoperative processes," says Roberts. The integration of the Kaiser patients into the UCSF Kidney Transplant Service reestablishes the arrangement that existed between the two medical centers before Kaiser started its own program in 2004. "We are working closely with our colleagues at Kaiser to carry out this transition, and look forward to working with them going forward," says Roberts. Details of Transition Plan
Under the plan, Kaiser patients awaiting kidney transplants will continue to be cared for by their primary nephrologist - or kidney specialist - at Kaiser as they undergo dialysis, an outpatient procedure used to sustain failed kidneys. At the same time, the patients' placements on the national kidney-donor "wait list" will be transferred into the UCSF and UC Davis medical center systems. A patient's time on the wait list is more than three years nationwide, and up to seven years in Northern California, given the number of patients seeking kidneys and the shortage of donated organs. As each patient's standing on the wait list rises to the top within his or her region, he or she will move into the care of the UCSF or UC Davis team for the involved process of preoperative evaluation and preparation, surgery and postsurgical care. "It's important for Kaiser and UCSF patients to know that they will not lose their place on the wait list as a result of the transition," says Stephen Tomlanovich, MD, medical director of the UCSF Kidney Transplant Service. This is because eligibility for a donated organ is determined by a patient's status on the national list and the region in which he or she is located, rather than the hospital in which he or she will be treated. As an organ becomes available in the San Francisco Bay Area, the patient who is highest within the region on the wait list - as determined by his or her wait time - will receive the kidney. Patient Eligibility
The process by which a patient becomes eligible for a kidney from a nonliving donor, or cadaver, is complex. To qualify for placement on the national wait list, a patient must first be evaluated by his or her nephrologist and deemed an appropriate transplant candidate, based on the patient's overall medical condition. As the patient's standing on the wait list rises, he or she is again evaluated. The ultimate decision for a patient to receive a transplant is made by the patient's potential surgeon, and is based on the quality of the organ match and the patient's medical condition at the time the organ becomes available. Patients who have been offered an eligible kidney by a living donor are able to undergo a transplant within a few months, if the patient's medical condition allows it and the donor is a successful match. Kidney disease, in which the kidneys fail to function properly, is caused by diabetes, high blood pressure and other disorders. Early detection and treatment can often keep chronic kidney disease from progressing. When it does progress, it may lead to kidney failure, which requires dialysis or a kidney transplant to keep the patient alive. The national kidney transplant list is managed by the United Network for Organ Sharing (UNOS), a nonprofit organization contracted by the US Congress to oversee the organ donation process. There are 66,700 people in the United States awaiting kidney transplants, 7,700 of whom are in Northern California. Each year, more than 5,500 people will receive a kidney from a living donor, which is an option because people are born with two kidneys, but only need one to function. Most people, however, await a kidney from a cadaver. Every year, more than 4,700 die while awaiting a transplant. For further information about UCSF's Kidney Transplant Service, go here. To learn how to become an organ donor, go here.
To accommodate the influx of patients, the UCSF Kidney Transplant Service, one of the premier transplant programs in the world, is expanding its physician and clinical resources, and significantly increasing nursing and administrative support staff. "We will maintain our commitment to the patients currently on our waiting list as we add the Kaiser patients," says John Roberts, MD, FACS, chief of the UCSF Division of Transplant Services. On Wednesday, May 31, 2006, the team received the medical records of the first group of Kaiser patients designated for the transition - seven patients awaiting new kidneys from living donors - and has begun the process of reviewing the records and scheduling introductory medical evaluation appointments. "The transition presents a challenge, but our team is committed to the process," says Roberts. UCSF Transplant Success
UCSF has performed more kidney transplants than any other institution in the world - about 7,500 since 1964 - and is the second-largest center for living-donor kidney transplants in the United States. Each year, the transplant team evaluates approximately 1,000 new patients for kidney transplantation and performs more than 250 kidney transplants. Its transplant success rate is one of the highest of all California programs, and the pediatric kidney transplant program is one of the largest in the United States. The UCSF service is distinguished for its success in treating the most challenging types of cases, and has "demonstrated its ability to support patients through the complex process leading up to a transplant and through the surgical and postoperative processes," says Roberts. The integration of the Kaiser patients into the UCSF Kidney Transplant Service reestablishes the arrangement that existed between the two medical centers before Kaiser started its own program in 2004. "We are working closely with our colleagues at Kaiser to carry out this transition, and look forward to working with them going forward," says Roberts. Details of Transition Plan
Under the plan, Kaiser patients awaiting kidney transplants will continue to be cared for by their primary nephrologist - or kidney specialist - at Kaiser as they undergo dialysis, an outpatient procedure used to sustain failed kidneys. At the same time, the patients' placements on the national kidney-donor "wait list" will be transferred into the UCSF and UC Davis medical center systems. A patient's time on the wait list is more than three years nationwide, and up to seven years in Northern California, given the number of patients seeking kidneys and the shortage of donated organs. As each patient's standing on the wait list rises to the top within his or her region, he or she will move into the care of the UCSF or UC Davis team for the involved process of preoperative evaluation and preparation, surgery and postsurgical care. "It's important for Kaiser and UCSF patients to know that they will not lose their place on the wait list as a result of the transition," says Stephen Tomlanovich, MD, medical director of the UCSF Kidney Transplant Service. This is because eligibility for a donated organ is determined by a patient's status on the national list and the region in which he or she is located, rather than the hospital in which he or she will be treated. As an organ becomes available in the San Francisco Bay Area, the patient who is highest within the region on the wait list - as determined by his or her wait time - will receive the kidney. Patient Eligibility
The process by which a patient becomes eligible for a kidney from a nonliving donor, or cadaver, is complex. To qualify for placement on the national wait list, a patient must first be evaluated by his or her nephrologist and deemed an appropriate transplant candidate, based on the patient's overall medical condition. As the patient's standing on the wait list rises, he or she is again evaluated. The ultimate decision for a patient to receive a transplant is made by the patient's potential surgeon, and is based on the quality of the organ match and the patient's medical condition at the time the organ becomes available. Patients who have been offered an eligible kidney by a living donor are able to undergo a transplant within a few months, if the patient's medical condition allows it and the donor is a successful match. Kidney disease, in which the kidneys fail to function properly, is caused by diabetes, high blood pressure and other disorders. Early detection and treatment can often keep chronic kidney disease from progressing. When it does progress, it may lead to kidney failure, which requires dialysis or a kidney transplant to keep the patient alive. The national kidney transplant list is managed by the United Network for Organ Sharing (UNOS), a nonprofit organization contracted by the US Congress to oversee the organ donation process. There are 66,700 people in the United States awaiting kidney transplants, 7,700 of whom are in Northern California. Each year, more than 5,500 people will receive a kidney from a living donor, which is an option because people are born with two kidneys, but only need one to function. Most people, however, await a kidney from a cadaver. Every year, more than 4,700 die while awaiting a transplant. For further information about UCSF's Kidney Transplant Service, go here. To learn how to become an organ donor, go here.