ECMC Kidney Transplantation

ECMC Kidney Transplantation Program Receives HRSA Grant

$1.2 million Grant Awarded for Social and Behavioral Interventions to Increase Solid Organ and Tissue Donation

BUFFALO, NEW YORK—Erie County Medical Center (ECMC) Corporation today announced the U.S. Department of Health and Human Services Health Resources and Services Administration (HRSA) has awarded a $1.2 million grant ($400,000/year for three years) to ECMC’s Regional Center of Excellence for Transplantation and Kidney Care for social and behavioral interventions to increase solid organ and tissue donation.

Thomas J. Quatroche Jr., PhD, President & CEO, ECMC Corp. said, “This important HRSA grant will further enhance ECMC’s Regional Center of Excellence for Transplantation and Kidney Care ability to provide the gift of life to patients seeking a critically important kidney transplant. Thanks to the dedication and clinical expertise of the Center’s physicians, nurses and support staff, a record 138 kidney transplants were successfully completed in 2017 and they are on pace to exceed that number in 2018. Their clinical excellence also led this year to a successful 5-year reaccreditation by The Centers for Medicare and Medicaid Services (CMS) for ECMC’s transplant program.”

To date this year, 90 kidney transplants (7 living donor; 83 deceased donor) have been performed at ECMC versus 71 kidney transplants (9 living donor; 62 deceased donor) through August 1, 2017, so it is anticipated that the total number of kidney transplants in 2018 will exceed last year’s total.

Liise Kayler, MD, MS, FACS, Program Director, Regional Center of Excellence for Transplantation and Kidney Care at ECMC; and Clinical Professor, SUNY Buffalo Department of Surgery, Division Chief, Kidney and Pancreas Transplant Program, said, “We greatly appreciate this grant from HRSA.  Living-donor kidney transplantation is the most successful form of renal replacement for patients with kidney failure.  Despite increasing availability of information about living kidney transplantation and donation, there remains a vast chasm between what professionals know and what patients understand.  We intend to close the information gap by developing an effective means of communication and explanation that we anticipate will result in improved understanding and informed decision-making to increase organ donation rates to benefit eligible patients whose lives can be saved through kidney transplantation.”

A significant barrier to transplant is the shortage of donated kidneys.  Adults with kidney failure have two treatment options for survival: dialysis (a machine that filters harmful wastes, salt, and excess fluid from the blood) or a kidney transplant.  For those who are eligible, a kidney transplant allows patients to live longer and healthier lives compared to dialysis.  Patients are encouraged to find a living donor for their kidney transplant because a kidney from a living donor typically lasts significantly longer than a kidney from a deceased donor.  While a live donor kidney transplant is the best option, many patients have difficulty asking others to consider being a living donor.  Developing innovative ways to inform and empower kidney failure patients and their close relations (relatives and friends) can equip them with essential knowledge and self-efficacy to fully understand the benefits and risks of living kidney transplantation and donation to make informed decisions.

The goal of this grant-funded project is to develop a comprehensive, understandable, literacy-appropriate video module that improves informed decision-making amongst kidney failure patients and their close relations.  Results will provide critical preliminary data for further studies aiming to test broader effects of the video intervention on racial/ethnic minorities and patients at earlier stages of chronic kidney disease.  The target audience will be involved in the development and design of the video intervention.  Effects of the video education intervention will be tested.  It is hypothesized that after exposure to the video education intervention, kidney failure patients will report increases in knowledge and self-efficacy related to the risks and benefits of living kidney transplantation and donation and close relations will increasingly inquire for additional information regarding donation.  This web-based peer-informed intervention has the potential for widespread dissemination to patients at all levels of the kidney disease process, including the potential to address health literacy challenges faced in accessing health information.

A drawback of many previous interventions is that members of the target audience were not involved in the design and development of the communication materials.  Innovative interventions to reach and provide comprehensive education to patients with kidney failure and their social networks regarding the opportunities, risks and benefits of donation in a manner respectful of their learning style needs are required to empower patients to make informed decisions.

One educational component of this project, named KIDNEYTIME, will include animated videos that are comprehensive, understandable and easy-to-use.  The videos will be developed in collaboration with the UB Department of Communications, kidney transplant recipients and living kidney donors at ECMC.  As part of a study, these videos will be shown to future transplant recipients, their family members and friends to determine if these patients are more willing to contact and better able to inform prospective living kidney donors.  Consultation with the Kidney Foundation of Western New York will contribute toward the development and design of this study.

More than 100,000 people are presently on the kidney waiting list and more than 35,000 new patients are added annually to the transplant waiting list.  Approximately 11,000 patients annually receive deceased-donor kidneys.  Approximately 5,500 living kidney donors step forward to donate kidneys each year.  Therefore is critically important to increase access to transplantation as a treatment option amongst patients with advanced Chronic Kidney Disease (CKD) and end-stage renal disease (ESRD).  The average kidney transplant recipient lives more than twice as long as the patient remaining on dialysis and enjoys a markedly improved quality of life.  Life expectancy after starting dialysis is 5.7 years.  After kidney transplantation, life expectancy is 15.8 years.  Limiting the time on dialysis by providing transplantation sooner is an important potentially modifiable risk factor for post-transplant outcomes.  Preemptive transplantation, performed prior to the need for dialysis, is associated with almost doubling of the 10-year patient survival compared to later transplantation and is the preferred treatment for all eligible patients, but is more likely to be an option when a living-donor is available.

ABOUT THE REGIONAL CENTER OF EXCELLENCE (COE) FOR TRANSPLANTATION AND KIDNEY CARE AT ECMC: The Regional COE for Transplantation and Kidney Care is equipped to treat patients at every stage of kidney disease or kidney failure.  ECMC’s transplant program has offered kidney transplants since 1964 and pancreas transplants since 2004. The experienced multidisciplinary team serves the community with consistently high scores in outcomes and transplant rates from deceased donors, and also offers laparoscopic (minimally invasive) donor nephrectomy (kidney removal) procedures to promote faster recovery for live kidney donors.  ECMC’s commitment to excellence and focus on the patient experience has led to high satisfaction for recipients and living donors alike.  With advanced therapies in desensitization and paired-donor exchange, ECMC’s living donor transplant program has also made more transplants possible.  ECMC is also positioned to remain in the forefront of major innovations in transplantation, such as steroid-free immunosuppression and the opportunity for patients to participate in ongoing research trials, offering patients leading-edge treatments.