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A Guide to Living Donation
last updated:
Wed, 9/22/2010 11:03 AM

Did you know there are multiple advantages to living organ donation? Transplant patients have a higher success rate after transplantation. They spend less time on the waiting list and are better prepared for transplant surgery since the timing can be planned. Patients have a better quality of life and better organ compatibility especially with blood related donors.

Here are some of the most common questions about living organ donation:

Who Can Be a Living Donor?

Friend
Family
Emotionally Related Friend

What Do You Do To Become A Living Donor?

Contact the Transplant Center at 901.516.8466 to begin a screening questionnaire

Who Pays For the Donor Testing?

Typically the recipient’s insurance will pay for the testing. This will be verified by one of our Financial Case Manager’s per case.

Who Pays For the Donor Surgery?

Typically the recipient’s insurance will pay for the operation and follow up in the post transplant clinic. This will be verified by one of the Financial Case Manager’s per case.

What Testing Will I Need To Complete My Evaluation?

  • We will begin with blood typing and crossmatching blood from donor and recipient
  • Other labs will include chemistries, complete blood count, clotting factors, 24 hour urine to assess kidney function, urinalysis, viral studies, other labs as needed
  • Procedural testing will include chest x-ray, CT scan, GFR (kidney function test), cardiac testing as indicated
  • Outside referrals or additional testing will be made as indicated

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Melissa Moore is a transplant coordinator for the Methodist University Hospital Transplant Institute in Memphis, Tennessee. For more information, contact the Transplant Institute at transplant@methodisthealth.org. All opinions expressed here are those of their authors and not of their employer. Information provided here is for medical education only. It is not intended as and does not substitute for medical advice. Locate a transplant surgeon in Tennessee or call 866.805.7710 for more information.

Remember your Transplant Medications
last updated:
Thu, 9/02/2010 2:09 PM

Ask any transplant patient and they will most likely tell you the most important thing they do to protect their transplanted organ is take their medications. These medications are so very vital. The medications that a transplant patient takes range from anti-rejection medications, to anti-virals and antibiotics to prevent opportunistic infections, to different vitamins and minerals that may be lost after transplant. All of the medications work together to keep the transplant patient healthy. However, it is not always easy to remember to take all these different pills. Here are a few tips for all patients to help remember to take the transplant medications on schedule:

  1. Take your pills at the same time as an activity you do everyday, such as brushing your teeth, or taking a shower. After a week or two of doing this, you will begin to associate taking your meds as a part of the activity and it should become a habit.
  2. Set an alarm as a reminder. Most of us carry our cell phones everywhere these days. You can set a daily alarm as your “pill alarm.” The only caveat to this is remembering to bring your pills with you if the alarm is set for the middle of the day. These alarms can also be set as a start up reminder on your computer for all those who are more tech-savvy.
  3. Place reminder cards in various locations. If you take your pills at work, place a reminder on the computer, if you’re at home place a sticker on the refrigerator or on the bathroom mirror. Just make sure the reminders are somewhere you will look every day.
  4. Ask a responsible and willing family member, friend or co-worker to support you with daily reminders. This can be especially helpful if the friend or family member also takes daily medications. You can make a pact to remind each other about taking your meds.
  5. Use a pillbox. This way you can easily look and see if you have missed a dose. Pillboxes eliminate second-guessing and are easily purchased at any drug store.
  6. Keep a chart or calendar. Once you take your medications for the day, place a check on the calendar. If you take multiple doses, divide the calendar squares into as many pieces as necessary to place the checks. This can be especially helpful if you have a pocket calendar, which can go with you everywhere.

These are just some small tips, which may help you remember to take your incredibly important transplant medications. There are many other ways to remember you just have to find what works for you. Once you get into the routine, it should easily become a lifelong habit that you never have to think twice about.

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Amanda Dean is a Nurse Practitioner at the Pre-Transplant Clinic. For more information, contact the Methodist University Hospital Transplant Institute in Memphis, Tennessee at transplant@methodisthealth.org. All opinions expressed here are those of their authors and not of their employer. Information provided here is for medical education only. It is not intended as and does not substitute for medical advice. Locate a transplant surgeon in Tennessee or call 866.805.7710.

Prevent Infection After Transplant
last updated:
Fri, 6/04/2010 10:55 AM

One of the biggest issues patients face after they have an organ transplant of any kind is the threat of infection. Transplant recipients are at a much higher risk for infection than the general public due to their immunosuppressive medications. These immunosuppressive medications are vital to prevent rejection of the transplanted organ. They act by decreasing the body’s response to fight off  “foreign” cells. This prevents the body from attacking the new “foreign” organ but it also decreases the ability for the body to fight off bacteria, viruses and fungi that may invade. This decreased ability to respond to “invaders” sets the transplant patient up for a higher likelihood of infection, including infections which could be life threatening. However, there are many simple steps that a transplant patient, and any loved ones in close contact, can take to help fight off infection.

  1. WASH YOUR HANDS. A lot. It sounds simple but your hands are in contact with your face hundreds of times a day. This gives invaders easy access to your mouth and nose, which are easy entry points to the body. The cleaner your hands are, the fewer bacteria there will be. 
  2. Avoid close contact with anyone who is ill with an infectious disease such as the flu, cold, or pneumonia. This includes close family members. The closer you are in contact with an infected person, the more likely you are to get an infection. 
  3. Avoid crowds for the first few months after your organ transplant. This doesn’t mean stay locked in your home. It simply means avoid the peak times at grocery stores, sit in a less crowded section of church, go to a matinee movie instead of the 7 p.m. showing and other small changes. Once your immunosupressive medications are decreased in a few months, you can go back to your normal routine. 
  4. Practice good food safety. Wash all your raw vegetables and fruits. Don’t consume raw meats, including raw oysters, and ensure your meats are cooked through fully. Shellfish are fine to consume as long as they are cooked properly. 
  5. Avoid contact with animal excrement. Don’t clean the litter box, fish tank, bird cage, etc. You can have contact with domestic animals, just remember to wash your hands afterward. 
  6. If you get any cut, scrape or open area on your skin, clean it thoroughly as soon as possible. Dress it with a dry dressing. If any sign of infection develops, severe redness, pus, foul smell, call your transplant coordinator. 
  7. Get your flu shot! You should get a seasonal flu shot every year, as well as the H1N1 vaccine. You should get both shots early in the flu season. If the flu season is longer than expected and the Centers for Disease Control recommends booster shots for high-risk individuals, transplant patients should get a booster. It is important to remember that can transplant patients and their in-home loved ones should ONLY get the injected flu vaccine and NOT the flu nasal sprays. The nasal sprays are live viruses designed for people with competent immune systems, whereas the injections contain a dead virus which is safe for transplant patients. Also, transplant patients should get a pneumonia vaccine every five years.

Overall, preventing infection after an organ transplant comes down to common sense. If its gross, and you touched it, wash your hands. If your friends look or sound sick, politely decline their dinner invitation. You don’t need to be afraid of germs after transplantation, you simply need to take precautions against them.

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Amanda Dean is a Nurse Practitioner at the Pre-Transplant Clinic. For more information, contact the Methodist University Hospital Transplant Institute in Memphis, Tennessee at transplant@methodisthealth.org. All opinions expressed here are those of their authors and not of their employer. Information provided here is for medical education only. It is not intended as and does not substitute for medical advice. Locate a transplant surgeon in Tennessee or call 866.805.7710 for more information.

Liver Transplant Waiting Lists
last updated:
Tue, 5/18/2010 10:56 AM

One of the most confusing parts of organ transplant is the waitlist. How organs are allocated, or distributed appropriately, is a complex process. Each organ on the transplant list uses a different system for allocation, that is, the way hearts are distributed is different from livers, which is different from kidneys. The allocation of livers for transplantation is based on the Model for End Stage Liver Disease, or MELD, score. The higher the MELD score, the sicker the patient is from their liver disease. 

This score is completely free of human bias and is calculated from three blood tests. These blood tests include creatinine, a measure of kidney function; total bilirubin, a measure of liver function; and INR, a measure of how well the liver is making factors that help the blood clot. These three values are entered into a complex mathematical equation to determine the MELD score. Time on the waitlist only becomes a factor in liver transplantation when two patients have the same MELD score, thus being equally sick, then the patient who has been sicker for a longer time period would get the liver first. Patients can qualify for extra MELD points in a few very defined situations in which the patient’s chance of dying sooner is high. Some of these situations include the presence of liver cancer, low blood sodium or acute liver failure in which the patient will likely die in a few days without a liver transplant.

Once these scores are determined they are entered into a nationwide database of waitlisted patients. The MELD scores are updated on a mandated schedule or when the patient’s condition worsens. When a liver becomes available it is offered within its geographical region to the sickest patients with the corresponding blood type first.

So basically, liver allocation is based on MELD score. A higher MELD score indicates a sicker patient. The higher the MELD score the higher the patient will be on the waiting list and thus more likely to get a donor liver sooner. Liver allocation is a complex process but with the addition of the MELD score as the waitlist criteria there is little room for human bias or “favoritism” in determining who gets the transplant and when.

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Amanda Dean is a Nurse Practitioner at the Pre-Transplant Clinic. For more information contact the Methodist University Hospital Transplant Institute in Memphis, Tennessee at transplant@methodisthealth.org. All opinions expressed here are those of their authors and not of their employer. Information provided here is for medical education only. It is not intended as and does not substitute for medical advice. Locate a transplant surgeon in Tennessee or call 888.777.5959 for more information.

Kidney Transplant Evaluation
last updated:
Tue, 5/11/2010 9:08 AM

During your pre-transplant kidney evaluation you will undergo several tests. This testing is necessary to ensure that you are optimally ready to undergo transplant surgery. Below are some of the tests that will be required:

  • Chest X-ray
  • Pulmonary Function Test
  • Arterial Blood Gas
  • Echocardiogram
  • Cardiac Stress Test
  • CTA of the Aorta and Iliac arteries (ultrasound if the patient is not on dialysis)
  • Carotid Ultrasound
  • Cardiac evaluation by a cardiologist if necessary
  • Pulmonary evaluation by a pulmonologist if necessary

This may not be an all inclusive list of testing and may be altered depending on your needs as a patient.

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Melissa Moore is a transplant coordinator for the Methodist University Hospital Transplant Institute in Memphis, Tennessee. For more information, contact the Transplant Institute at transplant@methodisthealth.org. All opinions expressed here are those of their authors and not of their employer. Information provided here is for medical education only. It is not intended as and does not substitute for medical advice. Locate a transplant surgeon in Tennessee or call 866.805.7710 for more information.

Promote Organ Donation to Save Lives
last updated:
Mon, 5/03/2010 3:46 PM

Methodist North Hospital recently partnered with Community Tissue Services and the Mid-South Transplant Foundation to promote tissue and organ donation awareness.

“Organ and tissue donation can save and improve lives in the Mid-South and across the nation,” said Lynne Wilson, MSN, RN, CNOR, Administrative Director at Methodist North. “Joining the donor registry gives hope to those in need of organ and tissue transplants, while leaving a legacy of generosity for the donor and his or her family.”

Several awareness seminars and educational activities were hosted to promote organ donation throughout the hospital. The Mid-South Transplant Foundation, a federally designated Organ Procurement Organization, sponsored a flag-raising ceremony to further generate awareness about donations. The ceremony was conducted by Boy Scout Troop #17 on a flagpole located near the front entrance of Methodist North Hospital.

Methodist North’s efforts for getting people signed to the tissue and organ donor registry will help the more than 2,288 Tennessee residents who are waiting to receive life-saving hearts, livers, lungs, kidneys and other organs.

For more information on how to become an organ and tissue donor, visit the Tennessee Donor Registry.

8 Reminders for Pre Transplant Clinic
last updated:
Tue, 4/20/2010 11:46 AM
  1. Update your phone numbers. This is such an important factor for the pre transplant nurses to have so they can update your file. The nurses at the pre transplant clinic need updated phone numbers on file so that we may contact you, especially if we get an organ donation offer.
  2. Always bring your medications or an updated list of meds you are taking so the nurse can verify for any changes. Medications can change during your evaluation and listing period, so it is important for the nurses to know exactly what you are taking.
  3. Bring your insurance card so that we can put the information on the chart. This information can change during your evaluation and listing period too, so please contact the center if your benefits change.
  4. Bring a support person. This is always helpful due to the amount of information that you will be given on your visit. Having someone else to help you remember and store everything will make your visits easier.
  5. Bring the names and numbers of other providers/physicians that are caring for you. Many times we will need to send a release of information to obtain other testing that may have been done at an outside facility. This will help with your evaluation and may prevent ordering unnecessary testing.
  6. Annual testing reports such as mammogram and pap smear should be with you. Women over 18 will need annual pap smears and women over 40 will need annual mammogram reports. Having these available may reduce your time in work up and facilitate your listing with UNOS.
  7. Be on time for your visits. We want to give you as much time as possible to go through your evaluation and ask any questions. We don’t want to rush you and this will show our staff your desire to work with us for your organ transplantation.
  8. Bring a list of questions you may have regarding transplant. Write these down prior to your visit so we don’t miss anything. Even with a good memory, it’s sometimes hard to recall questions you’ve thought about before your visit. We’re here to answer questions and support you through your organ transplant. If you have a question about a specific type of organ transplant, take a look these pages on Kidney Transplant, Liver Transplant, Pancreas Transplant and Kidney-Pancreas Transplant.

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Melissa is a transplant coordinator for the Mehtodist University Hospital Transplant Institute in Memphis, Tennessee. For more information, contact the Transplant Institute at transplant@methodisthealth.org. All opinions expressed here are those of their authors and not of their employer. Information provided here is for medical education only. It is not intended as and does not substitute for medical advice. Locate a transplant surgeon in Tennessee or call 866.805.7710 for more information.

Donate Life Month
last updated:
Mon, 4/12/2010 9:38 AM

Today you can save a life! April is here and with that brings national Donate Life month. On the first of the month, the United Network for Organ Sharing (UNOS) had record of 106,729 Americans waiting on solid organ transplants. Last year only 28,464 organs were recovered for transplant. 

At the Methodist University Hospital Transplant Institute, we currently have 501 people waiting on a life saving organ transplant. Last year, we were able to help over 250 of these patients. Through solid organ donation, organ splitting and living organ donors, you can help us save more lives, in less than five minutes today. Today is the day to decide if you want to be an organ donor. Registering is easy and each person who registers could save as many as 8 lives. The first step to take is to register as an organ donor in your home state. 

If you live in Tennessee, you can visit the TN Donor Registry. Here you can fill out a simple online form, which will automatically register you as an organ donor. Arkansas residents can indicate their donation preferences on the reverse side of their driver’s license and residents of Mississippi can visit Donate Life MS to become a registered organ donor. If you live anywhere else in the United States you can visit, Donate Life to find the laws regarding organ donation, and how to register, in your state.

The final step in deciding if you want to be an organ donor is simply telling your family your wishes. It may seem like a difficult discussion, but letting your family know your wishes will alleviate any confusion or stress in an already difficult time for them. There are many misconceptions about organ donation. If you have any concerns about organ donation you can visit www.donatelife.net to get the facts. Today is your day to be a hero. Please consider registering to be an organ donor.

You can also look for information about organ splitting, living donor kidney transplants, living donor liver transplants and other ways that you can make a difference for someone who needs an organ transplant. Donate Life!

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Amanda Dean is a Nurse Practitioner at the Pre-Transplant Clinic. For more information contact the Transplant Institute at transplant@methodisthealth.org. All opinions expressed here are those of their authors and not of their employer. Information provided here is for medical education only. It is not intended as and does not substitute for medical advice. Locate a transplant surgeon in Tennessee or call 866.805.7710 for more information.

Transplants in Memphis Tennessee
last updated:
Thu, 4/01/2010 1:01 PM

The Methodist University Hospital Transplant Institute has had a presence in Memphis for quite sometime and has been evolving at a rapid pace in recent years to meet the needs of our patients. To introduce ourselves today I wanted to share a few facts about why I am so proud to call the Transplant Institute home.

  • Patients have come to Methodist from across the United States for their transplant care. Recently, we have transplanted patients from as far and wide as Puerto Rico, Pennsylvania, Massachusetts, California, and Maryland, just to name a few. For those patients, we have overnight guest rooms available for their families.

  • The Transplant Institute is ranked as one of the top ten liver transplant centers in the United States

  •  The Transplant Institute has successfully performed over 420 living donor kidney transplants. Our living donor liver transplant program is currently being revitilized. 

  •  Any patient who has a transplant has more than 15 different health care workers who all contribute the transplant process. This includes surgeons, medical doctors, nurses, social workers, financial case managers, pharmacists and many others.

  • Since we began, the Transplant Institute has performed over 3300 solid organ transplants. In 2009, the transplant institute had a record year, performing 129 liver transplants, 122 kidney transplants, 2 pancreas transplants and 6 combined kidney-pancreas transplants.

  • A little history: The first kidney transplant was performed in 1970 at the UT Bowld hospital. The Bowld was the sixth kidney transplant program in the country. In 1984, the first liver transplant was performed, making UT the 3rd liver transplant program nationwide. In 2004, after many successful years, the Transplant Institute relocated to our new home at Methodist University Hospital. As you can see, the Transplant Institute is a busy place. We spend our time dedicated to ensuring every patient is given the best care during every aspect of their transplant experience.

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Amanda Dean is a Nurse Practitioner at the Pre-Transplant Clinic. For more information contact the Transplant Institute at transplant@methodisthealth.org. All opinions expressed here are those of their authors and not of their employer. Information provided here is for medical education only. It is not intended as and does not substitute for medical advice. Locate a transplant surgeon in Tennessee or call 866.805.7710 for more information.

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Methodist Healthcare is an integrated health care delivery system, dedicated to the art of healing through our faith-based commitment to minister to the whole person. 1211 Union Avenue, Memphis, Tennessee 38104 • (901) 516-7000

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