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News from the Emory Transplant Center: Integrating discovery, training, and patient-centered care
    May/June 2009  
         
 

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Sudha Tata
Dr. Sudha Tata

 

 

 

Emory on the Road

Referring physicians provide an important lifeline to patients from throughout the region who need comprehensive transplant services at Emory. Dr. Sudha Tata, ETC nephrologist, and Meg Jeffrey, outreach coordinator, are helping to build relationships with the physicians who provide much of our patients' care before and after their transplants. "Our patients are very glad when we are accessible to their referring physicians," Dr. Tata says. "They want their doctors to know what's going on at Emory."

Dr. Tata, kidney/pancreas transplant surgeon Dr. Tom Pearson, and Meg Jeffrey take time each month to visit referring physicians. These visits allow our referring physicians to meet face-to-face with members of the Emory Transplant Team to discuss patient and physician concerns. The physicians receive marketing materials with information about the programs and data about their patients. Many of these materials were created by Jo-Ann House, program coordinator, to communicate important information and new initiatives.

In addition to face-to-face visits, the team schedules conference calls with the transplant surgeons, transplant nephrologists, post-transplant coordinators and referring physicians to relay information about their patients' medical conditions and transplant wait list status. Dr. Tata is a major contributor on these calls and is able to update the referring physician group on all of their post-transplant patients. Susan Boteler, pre-transplant living donor coordinator, also contributes to these calls by reviewing all of the pre-transplant patients, discussing their status, and identifying action items to move the patients onto an active status on the transplant wait list.

Dr. Tata also reaches out to patients outside the Atlanta area through TELEMED, the ETC telemedicine project. TELEMED saves patients a trip to Emory. About two weeks before the TELEMED visit, patients receive a lab kit in the mail with HLA and viral serologies. "With TELEMED, we can talk with the patient about his or her medical condition using a computer screen here in my office. For the physical exam, we have a nurse who assists us with the patient, examining his or her eyes, ears, nose, and skin, providing auscultation of the lungs and heart with an electronic stethoscope, and using the technology on their end so we can see, hear and record the data here at Emory." Dr. Tata talks with the patient for 30 to 45 minutes about his or her labs and managment plan.

Dr. Tata leads the kidney transplant team’s outreach program with much energy and enthusiasm. "The team approach is the best way to provide the excellent patient care for which we are known," she says.

 
     
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Dr. James Spivey
Dr. James Spivey

Samir Parekh
Dr. Samir Parekh

 

Hepatology Fellowship Program Receives Accreditation

The Accreditation Council for Graduate Medical Education (ACGME) recently approved the ETC's transplant hepatology fellowship program. The ACGME's Resident Review Committee for Internal Medicine accredited the program effective July 1, 2009.

“We in the ETC have a strong desire to contribute to the development of the next generation of leaders in transplant hepatology," reports Dr. James Spivey, medical director of the liver transplant program. "I would especially like to thank Dr. Samir Parekh who wrote our application and will become the fellowship program's director in the near future. I would also like to thank our partners in the division of gastroenterology whose collaboration was essential for this application to be successful."

Dr. Ryan Ford will be the first transplant hepatology fellow to begin the program in July. A School of Medicine graduate, he completed his internal medicine residency and gastroenterology fellowship here at Emory. "Ryan exemplifies the quality of the applicants we expect for our positions in the future,” says Dr. Spivey. The program is approved for two fellows. The ACGME will review the program again in May 2011.

 
     
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Dr. Fiona O'Reilly Zwald
Dr. Fiona Zwald

 

Specialty Care for Transplant Patients

Transplant recipients are happy to see a familiar face providing care in the outpatient transplant clinic (OTC). Dr. Fiona O'Reilly Zwald returned on May 5 to provide dermatology services to patients on the 6th floor of The Emory Clinic Building B. She will be available on Tuesday and Wednesday afternoons. "Dr. Zwald has a special interest in caring for the transplant patient in both their pre-transplant and post-transplant experience," says Robin Pastush, administrator of operations at the ETC.

Another Emory dermatologist, Dr. Michael Sarradet, will join Dr. Zwald on the service and will begin seeing clients on Monday, July 6. He will have Monday afternoon appointments for transplant recipients.

To schedule patients, please contact the OTC's front desk or your transplant program's secretary.

 
     
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Dr. Chris Larsen
Dr. Christian Larsen

 

Larsen Honored With Distinguished Faculty Award

Dr. Thomas Lawley, dean of the School of Medicine, recently honored Dr. Chris Larsen, director of the ETC and Joseph Whitehead Professor and Chair of Surgery, with the Dean's Distinguished Faculty Lecture and Award. Dr. Larsen presented his lecture, "Transplantation: New Strategies to Promote Acceptance and Expand Applications" to faculty and staff on May 28.

"Dr. Larsen’s scientific achievements and inspirational leadership set a standard for others in academic medicine and offer hope to people everywhere who suffer from organ failure," says his colleague Dr. Thomas Pearson, chief of kidney transplantation and Livingston Professor of Surgery. "Dr. Larsen is an exceptional basic scientist who has the rare ability to translate innovation through the critical elements of translational research into clinical trials and clinical reality."

 
     
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<br>Dr. Kenneth Newell
Dr. Kenneth Newell

Dr. Stuart Knechtle
Dr. Stuart Knechtle

 

 

 

 

 

 

Dr. Mandy Ford
Dr. Mandy Ford

 

Developing New Immunosuppressant Regimens

ETC kidney/pancreas transplant surgeons Drs. Chris Larsen, Kenneth Newell, and Allan Kirk and liver transplant surgeon Dr. Stuart Knechtle will receive funding over five years from the NIH under the Clinical Trials in Organ Transplantation (CTOT) program. Emory is one of a handful of CTOT centers that will set the national agenda for new developments in organ transplantation and drug therapy. Emory is leading a consortium that includes University of Alabama Birmingham, University of California San Francisco, and Stanford University that will study belatacept-based immunosuppressant therapy regimens developed, in part, through 15 years of work at Emory. Belatacept is form of immunoglobin, which helps boost T cell (white blood cell) production. These regimens may help eliminate the long-term use of steroids and calcineurin inhibitors (CNIs), which can impact protective immunity and bring multiple side effects, such as kidney disease and an increased risk of cardiovascular disease.

With this funding, Emory is a national CTOT program leader for both adult and pediatric transplantation. In March 2008, Dr. Kirk received a five-year grant totaling approximately $6 million for the Clinical Trials in Organ Transplantation in Children (CTOT-C) program. Part of the CTOT-C program catalogues and defines how pediatric kidney transplant patients' T cell repertoires evolve as they get older. Another part of the clinical studies is developing a simple blood or urine test that can take the place of a painful biopsy to determine whether kidney transplant recipients are in the process of rejection.

In addition, Dr. Larsen and his colleagues will receive another two years of funding from NIH to extend their long-standing P01 grant, “Interactions of Protective Immunity and Transplant Tolerance.” This study expands the ETC's collaboration with Dr. Rafi Ahmed, professor of microbiology and immunology and former director of the Emory Vaccine Center. The two centers have been working for several years to develop new strategies for vaccination that can better protect organ transplant recipients and other immune-suppressed patients from infectious disease threats.

The P01 grant consists of three projects. In the first, Dr. Larsen and basic scientist Dr. Mandy Ford will study the strategies and mechanisms by which donor specific tolerance could be induced. In the second project, Dr. Kirk and hematologist/oncologist Dr. Leslie Kean will study the host’s relationship with herpes viruses, Epstein-Barr and cytomegalovirus, which cause significant morbidity after transplantation. Finally, Dr. Ahmed will study T cell memory and how it relates to pathogen development and is maintained in normal subjects and transplant recipients.

 
     
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ATC logo

 

BENEFIT Findings Presented at ATC

Dr. Chris Larsen and his colleagues presented the one-year findings from BENEFIT (Belatacept Evaluation of Nephoprotection and Efficacy as First-Line Immunosuppression Trial) at the 2009 American Transplant Congress in Boston on June 2. A three-year, randomized, phase III trial, BENEFIT showed that belatacept (see article above) works as well as the traditional immunosuppressive therapy of cyclosporine in maintaining renal function in kidney transplant recipients, despite a higher rate and severity of acute rejection.

The patients were randomized into three groups of recipients, including those who received a more intensive regimen of belatacept, those who received a less intensive regimen of belatacept, and those who received cyclosporine.

The study found that the patients receiving belatacept had the same patient/graft survival rates as those receiving cyclosporine, but belatacept patients had much better kidney function and better cardiovascular/metabolic profiles than cyclosporine patients. Also, belatacept was tolerated better and was safer than cyclosporine. However, cyclosporine was found to provide a lower rate and grade of acute rejection.

The researchers noted that the impact of acute rejection on the transplanted kidney's function and survival at 12 months was limited. Since there is a need for improved immunosuppressants, they will continue to assess the patients over the three years of the trial.

 
     
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Raja Laskar
Dr. Raja Laskar

 

Outreach Education on VAD

Cardiologist Dr. Raja Laskar gave a presentation on ventricular assist devices (VADs) at a recent Atlanta Chapter meeting of the Preventive Cardiovascular Nurses Association. About 50 nurses were in attendance. Ann Pekarek, nurse practitioner and VAD coordinator, gave a hands-on demonstration. Scott McCoy, who received a VAD implant in Feb. 2008, was there to share his experience before and after his surgery.

Emory Healthcare recently featured McCoy in a special article about how the VAD saved his life and allowed him to keep his active lifestyle.

Scott McCoy

Scott McCoy

 
     
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PFAC logo

 

Advisory Council: A Year in Review

The ETC Patient and Family Advisory Council celebrated its first anniversary on June 2. Over the past year, council members have been invaluable to the ETC, actively learning about our services so they can best partner with staff to improve programs and policies. The council has reviewed a variety of patient education materials, developed some of its own patient resource hand-outs with information on lodging and area restaurants, provided fundraising resources and support group information, and consulted with staff to revise donor communication policies. Council members have served as representatives on Emory Healthcare facility redesign and ETC service steering committees. They joined a speakers' panel at the EHC quality conference and participated in the hiring process for a new nephrologist. In addition, council members served as guest speakers, providing an overview of the ETC, outpatient clinic operations, and EHC quality improvement. Along with all this work, the council also drafted its own by-laws and held a holiday potluck!

patient advisory committee

The ETC Patient and Family Advisory Council

 
     
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Emory Healthcare

 

Focus on Quality Care

Ever vigilant to continue our mission to provide quality patient and family centered care, Emory Healthcare hosted its annual quality conference, "Huddle up for Quality," in April. This conference is part of a comprehensive, ongoing quality initiative to ensure outstanding patient safety, outcomes, and service.

Representatives from the ETC attended the conference and presented a poster. Casey King, Catherine Folowshele, Ginny McGrath, and Robin Pastush presented "Donor Net: Improving the Way We Secure Organs," which highlighted the ETC's call center and its use of a technology called Donor Net. Initiated in 2007, Donor Net has enhanced the services the ETC provides to both adults and children in multiple organ transplant programs. It helps manage a large volume of calls from surgeons and transplant coordinators while still meeting the ETC's and specific transplant programs' main goals of improving efficiency and eliminating duplicate services.

quality conference 2009

The Donor Net poster presentation

 
     
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Melvin Colley
Melvin Colley

 

With Thanks to the Kidney Transplant Team

Kidney transplant recipient Melvin Colley and his stepdaughter and donor, Shelly Embrick, recently wrote the kidney transplant team a gracious thank you note on his one-year anniversary to let the team know how well he was doing. "I remember my poor health condition a year ago," Colley wrote in March, "and how grim the days were. The kidney transplant saved my life and I thank my stepdaughter for her most generous gift of kidney donation."

 
     
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Donate Life flag raising
At the first flag raising

 

Flying High for Donation

The ETC raised its first Donate Life flag in front of Emory Hospital on June 11, signifying the beginning of Emory’s ongoing honor and awareness organ donation campaign. The flags will be raised at Emory Hospital and Emory Hospital Midtown when a family at one of these hospitals donates a deceased organ for transplant or when a living-donation takes place. A smaller, boxed version of the flag will be presented to the donor family or living donor.

flags over EUH

Flags over EUH

 
     
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Donor Week 4-09
Ann Seichrist and Beverly Williams

Beverly Williams
Beverly Williams and Neile Chesnut

 

Donor Week a Success

April 17 to 23 was a busy time as the ETC celebrated National Donor Month with a week's worth of special activities to educate others about the importance of organ and tissue donation. "This was our most successful Donor Month ever," remarks Meg Jeffrey. She and Jo-Ann House organized a number of activities involving 25 staff members, donor families and transplant recipients.

At a staff lunch-and-learn, both Ann Seichrist, who donated her son's heart to Beverly Williams, and Beverly spoke eloquently to staff about their experiences. In appreciation of their heartfelt and emotional presentation, Ann was awarded the ETC's first Donate Life flag. During the week, ETC staff talked about the importance of donation and distributed donuts to students, staff, faculty, and visitors on Emory’s campus.

In addition, LifeLink of Georgia displayed its colorful quilt celebrating donor families. Living donors and families of deceased donors provided memory squares that decorate the quilt. On April 22, Bobby Howard, manager of multicultural donation education at LifeLink, presented his personal experience about the importance of donation. LifeLink volunteer families also presented their stories at special displays.

Donor Week quilt 4-09

Jennie Perryman, Ann Seichrist, Beverly Williams, Meg Jeffrey and Neile Chesnut

 
     
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Donate Life GA
Donate Life's Facebook

 

Organ Donation Made Easier

Making your wishes known for organ, eye and tissue donation is now much easier. You can register your donation decision online at the Georgia Donor Registry, which is maintained under the direction of LifeLink of Georgia and supported by Donate Life Georgia. Many thanks to those faculty and staff who contributed to the Revised Uniform Anatomical Gift Act, which helped fund this web-based registry.

 

 
     
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Jennifer Hutchinson
Jennifer Hutchinson

Dr. Hetal Karsan
Dr. Hetal Karsan


Dr. Clinton Lawrence

 

Degrees, Awards and Accomplishments

  • Catherine Folowoshele, a former intern in the kidney and liver transplant programs, received a Master of Public Health degree from the Rollins School of Public Health on May 11. She currently has accepted a position with the Centers for Disease Control and Prevention.
  • Dr. Seth Force, surgical director of lung transplantation, was promoted to associate professor of surgery.
  • Jennifer Hutchinson, a research nurse in the transplant clinical research program, completed a masters degree in nursing education from Regis University in Colorado in May. She came to the ETC in March and also works weekends part-time as a nurse at Children's Healthcare of Atlanta's pediatric ICU.
  • Hepatologist Dr. Hetal Karsan passed his Certificate of Added Qualification (CAQ) exam in transplant hepatology. The CAQ is an American Board of Internal Medicine-certified examination.
  • Dr. Clinton Lawrence, Augustus McKelvey Professor of Medicine and director of the McKelvey Center for Lung Transplantation and Pulmonary Vascular Diseases, released a CD, “Arrows From a Warrior’s Quiver.” The CD is a compilation of 14 songs written by Dr. Lawrence and is available at the Emory bookstore and on his blog.
  • Physician assistant Holli Paulk was promoted to the new position of manager of clinical services and operations for the McKelvey Center on June 1. Paulk also received an MBA in Healthcare Administration from the South University in Savannah, Ga., on June 20.
  • Dr. Andrew Smith recently celebrated his 50th birthday by bicycling 100 miles from Atlanta to Anniston, Ala.
 
     
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Keri Levin
Keri Levin

Lauren Taylor
Lauren Taylor

 

New Staff

  • Keri Levin joined the ETC as a nurse in the outpatient transplant clinic. A native of South Georgia, she graduated from Georgia Southern University and has experience in the ICU at St. Joseph’s Hospital in Savannah and in the outpatient general surgery unit at Southeast Georgia Health System in Brunswick. Levin and her husband, Eric, married in June of 2008 and moved to Atlanta this year, lured by her interest in Emory's transplant program. The OTC is already celebrating her skills in starting IVs! In her spare time, she enjoys movies and shopping.
  • Lauren Taylor is a new clinical research nurse in ETC's clinical research program. Originally from Baltimore, Md., Levin graduated from Elon University and Duke University School of Nursing in N.C. Taylor has experience in neonatal ICU nursing as well as in research, working as a clinical research nurse coordinator for an allergy, asthma and immunology practice in Dunwoody for the past year. Her interest in transplantation is personal; her father received a successful kidney transplant in 2004. Taylor enjoys spending time with her boyfriend and exercising in spin classes and by running.

 

 
     
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ETC icon
 

In the News

The following are some interesting news stories featuring the ETC:

  • Watch the inspiring story from 11Alive about Marlene Valentine, who donated one of her kidneys to her grandson, Andrew, 5, at Children's Healthcare of Atlanta at Egleston.
  • Check out the story on Lisa Thomas, a patient with end-stage kidney disease, on Salisbury Post.com, a guide to Rowan and Cabarrus counties in N.C. The article features information on the matching and transplant process from Erika Henderson, living donor renal transplant coordinator at EUH.
  • Watch the story on Fox 5 News about Andrew Story, 7, who received a donor kidney from his baseball coach, Army Ranger First Seargent Corey Meyers. Meyers' surgeon, Dr. Nichole Turgeon, is inteveiwed. Emory's version of the story is here.
  • Find out more about Throne Johnson, who is on Emory's waiting list for a heart transplant, at WALB News 10. Bikers from his hometown of Albany, Ga., held a fundraising drive on May 9 to help pay for his post-transplant medications.
  • For an intruiging perspective about becoming a potential organ donor, read the April 16 blog in The New York Times health section.
 
     
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scrapbook graphic

 

ETC Scrapbook

The ETC recognized its very talented nurses at the fourth annual Transplant Nurses Day on April 15. They enjoyed a reception to honor the ETC's nursing professionals who care for patients, living donors, and their families and help them through the challenging time leading up to, during, and following transplantation.

Transplant Nurses Day09

Several of the ETC staff administrative group took on Stone Mountain as one of the ETC’s external gallup teambuilding initiatives. As you see, they made it to the top, symbolizing where ETC and EHC rank to them…the TOP!!

administrators on Stone Mtn.

Also, how often does this happen? Hepatologist Dr. Hetal Karsan threw the first pitch for a recent Cubs game at Wrigley Field. He has a nice wind-up, don't you think?

Hetal Karsan-CubsKarsan family-Wrigley

 
     
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