Cleveland Clinic'sTransplant Center's Aggressive Program to Shape Nat'l Protocol

Even though thousands of Americans are in need of organ transplants, some hospitals may not add them to a waiting list if there are too many risks, nor will surgery be performed unless an organ is a perfect match. Cleveland Clinic, however, performs nearly 500 transplants a year, which means we have the experience to care for sicker patients and to accept organs from a wider range of donors, while still maintaining excellent outcomes.

Soon, these practices may be duplicated nationwide, because the Health Resources and Services Administration (HRSA) is incorporating our heart, lung, liver, kidney and pancreas transplant programs into a new transplantation initiative. HRSA hopes this initiative will improve the performance of transplant hospitals nationwide and in turn, increase donor-recipient matches. Cleveland Clinic is one of only nine U.S. hospitals selected by the HRSA to help shape the program.

Practice makes perfect
"Cleveland Clinic has a reputation for really pushing the envelope," says Transplant Center Administrator, Art Thomson, explaining that the transplant team not only lists sicker patients (i.e., adds them to a waiting list for an organ), but in some cases, accepts organs that others might consider unusable. For example, when an organ becomes available to a Cleveland Clinic patient, but there are doubts about the quality of the organ, a team will visit the organ - even if it means flying out of state - to personally evaluate it.

Larry Forbes, CRNFA, along with associate staff cardiac surgeons, leads the fly-out team and has flown as far as Florida and Texas to examine organs, run tests and do blood work to decide whether to bring them to Cleveland Clinic. Each year, additional transplants are made possible by their efforts.

Some smaller hospitals have begun to adopt an approach similar to Cleveland Clinic's, in which they evaluate organs that they previously considered unusable and turned away, according to Thomson. "The more risks you take and prove you can be successful with, the more you can push the envelope," adds Clinical Manager Renee Bennett.

The job is 24-7, and patients are lifelong
A single transplant is made possible by hundreds of people, from donation, pre-transplant and post-transplant coordinators to surgical teams who perform the implantation - and the list goes on. "Our program has succeeded because of the people who make it run," says Thomson.

Employees learn to adjust to odd hours and late-night pages, and the key to the team's success is that everyone is willing to do what it takes to make the operation run successfully. In many cases, that means getting up in the middle of the night to answer calls or respond to patients.

The team's unwavering service means a great deal to patients, who depend on Cleveland Clinic long after they've been discharged post-transplant. "We support patients for the rest of their lives, beginning the moment they are referred," says Transplant Center Director John Fung, M.D., Ph.D. "These are lifelong patients.