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Organ transplant
Patient Information
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Transplant Center - What's New
May, 2007
Issue #7
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Obesity can complicate liver transplantation
Nationally, obesity is a significant but common problem in patients being considered for liver transplantation.
The statistics compiled by the Centers for Disease Control and Prevention for Kentucky show a significant increase in obesity in the general population resulting in a BMI greater than or equal to 30 over the last 20 years. The propensity of our populace to be significantly overweight, coupled with the state’s ranking of first in the nation for both men and women who smoke cigarettes, requires our programs to have substantial experience with treating obese patients with liver disease. Because of the co-morbidities accompanying obesity, these patients always present with both medical and surgical challenges for liver transplantation.
Our criteria for listing patients for liver transplantation allow a patient to have a BMI of up to 40. Patients are closely followed and counseled to lose weight as they progress through evaluation for transplant surgery. While optimal weight ranges for patients are always desired and encouraged, we realize that patients with higher than “average” BMI must be considered to have liver transplants in order to survive. Our location in an area of the country where obesity is so common has allowed us to expand our experience in post-transplant critical care management of these patients. We also offer diabetic counseling and have a registered dietitian on staff to help our patients with weight reduction and management both pre- and post-transplant.
We look to collaborate with referring physicians to work with our patients to achieve optimal weight management and to reduce perioperative and post-transplant complications.
Patients referred early show signs of better outcomes
Liver transplants are most successful if performed at the optimal time during progression of disease. Optimal timing is based on a history of the disease and the potential for progression over time. The patient must be in the system in order to have the opportunity to undergo the transplant, i.e. the evaluation must be completed and he/she must be listed with the United Network for Organ Sharing. Often, patients are not referred until late in the stage of their disease when their need has become immediate. At the UK Transplant Center, we perform rapid evaluations when necessary and have been successful with this rapidly deteriorating end-stage type patient, but outcomes are consistently and statistically less complicated when a patient has been seen early in the disease process.
We work with the referring physicians to help manage their patients’ liver disease while the patient is on the national list and waiting for a transplant. This includes performing blood tests as dictated by the patient’s MELD (Model for End Stage Liver Disease) score so that we can constantly evaluate the patient’s status on the waiting list. This also includes management of various complications such as ascites, spontaneous bacterial peritonitis, hepatorenal syndrome, etc.
Patients can be referred by calling the Transplant Center at 1-800-808-3212 or the transplant surgeon on call can be consulted via UK•MDs at 1-800-888-5533.
Transplant nurse coordinators obtain national credentials
Our nurse coordinators have recently passed national tests to earn the Certified Clinical Transplant Coordinator (CCTC) credential.
This rigorous examination is given by the American Board for Transplant Certification. CCTC is a highly regarded designation certifying to the public, referring physicians and other health professionals that our transplant nurse coordinators are at the top level of national standards of nursing practice in the management of transplant patients.
UK nurses already meet a higher national nursing standard, as UK Chandler Hospital has been designated a Magnet hospital for its outstanding nursing care. The national Magnet Hospital Recognition Program® was developed by the American Nurses Credentialing Center to identify and recognize excellence in nursing services. It is the highest honor a hospital can receive for its nursing services.
CCTC nurses require ongoing education in the field of organ transplant patient care. Recertification every three years ensures the nurses’ dedication to competency in the rapidly changing methodology and technology of transplant knowledge.
The physicians and supporting staff at the Transplant Center wish to acknowledge the hard work and dedication of the transplant nursing staff.
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