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History and Experience

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History and Experience History and HO Experience H3CO CH3 O H3C O OH CH2 N O CH3 O O HO CH3 O For more than years, UPMC Transplant Services H3C OCH3 H OCH3 30 has forged new treatments and innovative research that has allowed the field of transplantation to thrive around the world. With this historical excellence in the field of solid-organ transplantation that has defined UPMC, our program has been consistently challenged with some of the most difficult and complex cases. Despite this, we maintain outcomes that are on par with national benchmarks. This book is a comprehensive resource with information about our robust transplant programs. It is meant to assist you in determining if your patients would benefit from such treatments. Our Transplant Services PROGRAM HIGHLIGHTS PROGRAM HIGHLIGHTS Heart > Began performing > Performed the world’s > Second program in the Artificial > Began performing > Became the first medical heart transplantation first heart-liver transplant world to surpass 3,000 VAD implantation center in the world Transplant in 1980. in 1984, and the world’s heart, lung, and heart-lung Heart in 1987. to discharge a patient Program first heart-liver-kidney transplants procedures Program with a VAD in 1990. transplant in 1989. in 2012. Summary Who is eligible? Summary Our surgeons and cardiologists are If patients waiting for a transplant become The UPMC Artificial Heart Program is integrated international leaders in heart transplant too sick before a suitable donor becomes with the UPMC Heart and Vascular Institute The HeartWare® HVAD left ventricular assist research. Such work has continued to available, they are evaluated for a ventricular and world-renowned UPMC Heart Transplant device has been approved improve the care and outcomes for heart assist device (VAD) to support their heart Program for truly comprehensive care. Program for bridge to transplant. transplant patients. We have pioneered function, relieve their heart failure, and allow leaders have authored widely published research techniques in high-risk cases, and the use them to wait at home with better exercise and are internationally regarded as pioneers of multiple-organ transplants. We are able tolerance and quality of life until they receive in VAD development and application. This to successfully handle complex cases because a transplant. This tailored, patient-centered program features a full complement of physicians, the breadth of experience at UPMC ensures approach continues after transplantation: nurses, and bioengineers working together 24/7 that patients receive care that is best suited our experience and resources ensure that along with referring physicians to co-manage all to their unique clinical needs. treatment strategies are individualized for aspects of patient care. The Thoratec HeartMate II® each patient. Unfortunately there are more patients waiting A VAD, or a ventricular assist device, is a left ventricular assist device has been approved for transplant than suitable donors, so most device that pumps blood for patients with a for bridge to transplant and patients have to wait a long time for transplant. weakened heart muscle. Blood flows from for destination therapy. Patients listed at our center have significantly the heart to the VAD, which then pumps it to shorter average waiting times until the body’s circulatory system. The VAD is transplantation, compared with national Who is eligible? typically used one of two ways: and regional averages. As a bridge to transplant — Patients get • Who is eligible? General indications for heart transplantation include patients with: a VAD so that they can then wait for heart transplantation while in a more • End-stage heart failure that fails to respond to maximal medical Candidates for VAD implantation include: therapy including intravenous drugs stable condition. • Patients with advanced heart failure, who may be eligible • Severe coronary artery disease with untreatable angina • As destination therapy — These patients live on the pump as an alternative to for transplant, but are too sick to wait for a heart to • Cardiogenic shock transplantation as outpatients. VAD become available • Recurrent ventricular arrhythmias technology for severe heart failure improves • Patients who have advanced heart failure but are not transplant • Congenital heart disease with heart failure that cannot be quality of life for patients and allows them candidates either because of other medical problems or age surgically repaired to live a life free of heart failure symptoms. • Severe hypertrophic heart disease TO MAKE A REFERRAL, CALL 1-800-544-2500. PROGRAM HIGHLIGHTS PROGRAM HIGHLIGHTS > Began performing lung > One of the most active Lung transplantation in 1982. ECMO (extra-corporeal Lung > Began performing lung > membraneOne of the mostoxygenation) active > In 2016, our program Kidney > Began performing > National leader in > Expertise in Transplant transplantation in 1982. ECMO (extra-corporeal performed its 2,000th kidney transplantation solid-organ and minimally invasive Transplant centers in the country. Transplant Program membrane oxygenation) lung transplant, more in 1966. living-donor kidney living-donor Program centers in the country. than any other center Program transplantation. surgery. Program highlights in the country. Summary Summary UPMC’s Lung Transplantation Program is management, to surgery. Our physicians are lung and result in transplantation of lungs More than 26 million Americans have kidney While the typical wait for a deceased-donor waiting time. UPMC clinicians will educate one of the most experienced centers in pioneers in the use of ECMO, or extra-corporeal that were previously determined to be disease, and millions more are at risk. For many kidney transplant ranges from two to six years, a potential living donors about the procedure the world for lung and combined heart-lung membrane oxygenation, which replaces the unsuitable. Through ex vivo lung perfusion, we patients with end-stage renal disease (ESRD), living-donor transplant can usually be performed and determine whether donation is his or her transplantation. Since our program’s inception heart and lung function by circulating the hope to expand the utilization of donor lungs kidney transplantation is a viable, lifesaving within a few months. UPMC offers patients best option. Early referral for a living-donor in 1982, we have performed more than 2,000 patient’s blood through an artificial lung. and offer this life-saving therapy to more option. The UPMC Kidney Transplant Program one of the nation’s most experienced teams kidney transplant is key. It allows our lung and heart-lung transplants. The UPMC UPMC is also actively involved in research patients with end-stage lung disease. brings decades of experience in both dedicated to living-donor kidney transplantation. dedicated team to provide comprehensive Lung Transplantation Program works within the pertaining to organ perfusion. Perfusing the deceased-donor and living-donor transplants. Living-donor kidney transplantation consistently assessments and determine if living-donor UPMC Comprehensive Lung Center to provide organ outside of the body (ex vivo organ The significant expansion of UPMC’s exclusively improves both graft survival and patient survival kidney transplant is an option. With this exceptional care for patients along the entire perfusion) can improve the quality of the donor laparoscopic (minimally invasive) live donor compared with deceased-donor transplantation. option, the recipient can avoid spectrum of life-threatening lung diseases. program provides another option for patients dialysis altogether. Other advantages include a lower incidence Approximately 30 percent of our recipients have awaiting transplant. Although a kidney transplant of complications, less delayed graft function, been declined for lung transplantation at other is a complex, serious procedure, we maintain a shorter hospital stay, and elimination of centers. Our clinical experience and dedicated a personal, patient-focused approach that takes support resources have allowed our specialists into consideration the stress and concerns that to medically manage the most complex cases, many individuals experience throughout the including pulmonary parenchymal disease Who is eligible? evaluation, operation, and recovery period. Who is eligible? that significantly limits life activities despite Living Donation previous surgical and medical therapy. UPMC lung and heart-lung transplant specialists care for people with life- Candidates for kidney transplants include: threatening lung diseases. Diseases treatable by transplantation therapy include: Living-donor kidney transplantation provides We share insight and knowledge with our • Patients suffering from end-stage renal disease. colleagues so that each patient receives the a way for patients to overcome the limitations • Chronic obstructive pulmonary • Bronchiectasis Patients do not have to be on dialysis to be evaluated for or receive a transplant. individualized treatment he or she needs, of the waiting list, with improved outcomes disease (COPD)/emphysema • Retransplantation for For some individuals, a kidney transplant may not be an option due to other medical from pulmonary rehabilitation to medical compared with deceased-donor kidneys. • Idiopathic pulmonary chronic rejection problems. These conditions can be identified based on your input or during our fibrosis (IPF) • Pulmonary fibrosis related to initial evaluation. • Cystic fibrosis collagen
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