A Kidney Transplant: the Best Treatment for the Right Patients
By Joyce F. Jackson
President and CEO
Northwest Kidney Centers
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Original Publish Date: April 3, 2015
For many people with chronic kidney failure, a kidney transplant offers the best chance at the kind of life they enjoyed before diagnosis. Transplant recipients often live longer, feel better and have more independence than patients who undergo dialysis, the only other treatment option if chronic kidney disease progresses to Stage 5 kidney failure.
A transplant isn’t a cure, but success rates are high—after one year, 96 percent of transplants from living donors and 90 percent of transplants from deceased donors are still working. Anti-rejection medications are a daily requirement for life, but most transplant recipients are able to live with relatively few health restrictions.
Although our everyday business is providing dialysis, Northwest Kidney Centers’ mission statement declares that we will promote the optimal health, quality of life and independence of people with kidney disease. Sometimes that means helping people get off dialysis or avoid it entirely.
Our organization recognized the benefits of kidney transplants when it established an internal task force to give more patients access to the procedure.
A Better Way to Coordinate and Track Transplant
In 2009, Northwest Kidney Centers launched its Improve Kidney Transplantation Initiative, a program focused on educating patients and staff, creating a better system to track patients’ progress toward approval for a transplant, and removing common barriers to transplant.
“We want our patients to have access to the best treatment possible and for some, that’s a transplant,” says Dr. Leanna Tyshler, transplant liaison and CKD and clinical quality initiatives medical advisor at Northwest Kidney Centers. “But the transplant process is complex and patients understandably find it challenging to navigate. We needed an infrastructure to address patients’ needs before, during and after transplant.”
With Dr. Tyshler at the helm and a newly appointed transplant coordinator at her side, Northwest Kidney Centers put new transplant measures and standards into effect.
At the program’s launch, Northwest Kidney Centers convened Transplant School, an all-day education program attended by 88 staff members directly involved in managing dialysis patient care. They learned about new internal procedures, about the evaluation process for transplant candidates, and the best ways to help patients move up on the waitlist. We repeated Transplant School in 2014, with 66 staff members attending.
Each patient’s interdisciplinary care team—physician, nurse care manager, social worker and dietitian—now make it a point to discuss transplant-related issues with patients at least once every six months. The conversations are noted in the electronic medical record, keeping the care team up to date with each patient’s transplant status.
Regular communication by Northwest Kidney Centers with the three local hospital transplant programs ensures patients don’t drop off the transplant list for any unexpected reason.
Increasing Awareness About Transplant
With internal systems in place, the next step was to better educate patients and the greater community about transplant.
We teach patients to speak up to friends and family about their search for a kidney donor. If a compatible living donor volunteers, the transplant can proceed quickly. If the patient must wait for a kidney to be available from a deceased donor, the wait can be months or years.
Northwest Kidney Centers shepherds the process for each patient who is interested.
“Many patients don’t know that they can be evaluated and listed for kidney transplant before even starting dialysis treatment,” says Tyshler. “Knowing your options, and starting the transplant workup process as soon as you decide to pursue transplant, are key.”
Thanks to community philanthropic support, Northwest Kidney Centers established a curriculum and offers free classes about transplant for patients at every stage of kidney disease. “Choices” introduces transplant as one possible treatment for kidney failure. “Next Step Transplant,” for patients who want to learn more, discusses ways to prepare for a transplant, different types of donors, and how the waitlist works. And “Living Well With a Transplant” offers tips from a pharmacist and dietitian to keep recipients healthy for a lifetime. In 2014, 752 people attended these three classes.
Transplant recipients have access to Northwest Kidney Centers’ renal-specialty pharmacy where they can consult with a pharmacist familiar with medication interactions and kidney complications. We also send them “Transplant Connection,” a twice-yearly newsletter packed with health tips directly relevant to taking care of a transplanted kidney.
Northwest Kidney Centers brings transplant stories and facts to the greater community at large through a quarterly community newsletter, outreach events and an active social media presence. For example, in 2014, the nonprofit worked with a local transplant center to post coverage on Twitter as a patient’s transplant surgery took place. A local TV news crew taped in the operating room. The transplant center calculated that social media posts alone generated 89,000 impressions to spread the word about kidney health and the need for kidney donors.
Removing Barriers to Transplantation
In 2007, a high level of protein in his urine sent Qi Zhang to a kidney specialist. After more tests, the diagnosis came—kidney disease, Stage 4.
“It caught me by surprise,” says Zhang. “I had low energy and lower back pain. I didn’t know it was kidney disease-related.”
Zhang started dialysis at Northwest Kidney Centers in April 2013. Although dialysis made him feel better, he hoped for a transplant. To prepare, Zhang followed a low-sugar, low-salt diet and refrained from smoking or drinking alcohol or caffeine.
Still there was a major barrier in his way.
Patients must have a mouth completely clear of infection to be eligible for a transplant. Zhang needed dental work he couldn’t afford. He turned to the Access to Dental program, a joint venture launched in 2009 between Northwest Kidney Centers and the Seattle-King County Dental Society. The program matches low-income dialysis patients with volunteer dentists and oral surgeons. Through it, Zhang was able to get the dental care he needed to be cleared for transplant surgery.
On May 8, 2014, Zhang got his new kidney.
“I am thankful for the second chance,” says Zhang. “My life now is full of hope.”
Since October 2009, the Access to Dental program has referred 159 dialysis patients for dental services, and 32 of them have subsequently received a transplant.
More patients on the waitlist, more receiving transplants
The transplant initiative is working.
- In 2014, Northwest Kidney Centers saw a 14 percent increase in the number of its patients receiving kidney transplants, while the number of transplants nationwide decreased by 16 percent.
- In the three years ending in 2013, Northwest Kidney Centers’ transplantation rate was 80 percent higher than the national average.
- A total of 28 percent of Northwest Kidney Centers’ patients are on the transplant waitlist—25 percent is average.
Northwest Kidney Centers is a not-for-profit, locally managed provider of kidney dialysis, public health education and research into the causes and treatments of chronic kidney disease. Founded in Seattle in 1962, it was the world’s first dialysis organization. The 10th-largest dialysis provider in the country, it is an influential model because of its high quality services, deep community connections and generous donor support.