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At UAB, kidney transplants reach 10,000
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In November 2017, the University of Alabama at Birmingham kidney transplant team performed its 10,000th kidney transplant.
The transplant program at University of Alabama at Birmingham (UAB) began in 1968 when forward-thinking department of surgery chairman John W. Kirklin, MD, recruited Arnold G. Diethelm, MD. The finer points of immunosuppressive medications and tissue typing were still unknown and even in the late 1960s, transplantation was considered by many to be an experiment. The kidneys were a good place to begin. The kidney was easy to place and dialysis, also in its infancy, was a backup.
The 1980s saw rapid advancement in transplantation; however, erythropoietin was virtually unknown and calcineurin inhibitors were just becoming available. A post-transplant hospital stay was often 6 weeks.
Today, UAB has four transplant surgeons who perform many of the procurement surgeries in a dedicated OR on site to decrease ischemia time. There is an active incompatible program and an ongoing, paired exchange (chain) program for living-unrelated transplantation that is the largest in the country from one transplant center. More than 80 patients have received kidneys through the UAB chain.
In addition to being a high-volume program, UAB was the first transplant center in the South to transplant a kidney from a HIV-positive donor into a HIV-positive patient. UAB is also a leader in transplantation in children. To improve its living-donor process, UAB has initiated a Living Donor Navigator program to facilitate contact between recipients and potential living donors.
Transplant nephrologists and surgeons all credit the vision, enthusiasm and devotion of Diethelm for the center’s success. In addition, there is teamwork among all members of the team and longevity — there has been relatively little turnover among the faculty and nurses. The surgeons and nephrology providers work together with joint rounds, joint outpatient clinics and joint conferences.
One of the exciting potential treatments of the future that is being studied and pioneered at UAB is xenotransplantation, or transplantation between species. Pigs will be the donors.
The success of UAB’s kidney transplant program has many components which all began with a vision, and has developed through teamwork from the clinical staff, social workers, pharmacists, practitioners and physicians.
Acknowledgements: The author would like to thank Clifton Kew, MD, Roslyn Mannon, MD, and Bruce Julian, MD, of the UAB kidney transplant program in providing information for this article.
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- Jane Davis, DNP, CRNP, is a practitioner with the nephrology division at the University of Alabama at Birmingham.
Disclosure: Davis reports no relevant financial disclosures.