As a small, well-staffed program, personalized care and service are hallmarks of the Organ Transplantation program at HackensackUMC. When you undergo transplantation, you are making a lifetime commitment to your health. But, you're not doing it alone. From your first appointment through your entire post transplant period, the continuity of your care is coordinated by a specially trained nurse who is readily available to answer your questions and help you through the process of transplantation. In addition to your nurse coordinator, physicians will oversee your care, and a pharmacist, social worker, nutritionist and a financial counselor will provide you with the information and resources you need to be a full participant in your care.
Transplant Evaluation Process
First you will undergo an evaluation that will assess your physical health status and eligibility for surgery. Since transplant candidates have many emotions and questions surrounding the procedure and the care and lifestyle afterwards, you’ll also be evaluated for mental health and support services needs. And, to ensure you understand and have access to the financial resources specific to your care, a Financial Counselor will work with you and your family.
Regardless of the type of transplant you may undergo, special blood tests will be needed to match a donor organ for you. Among the tests performed will be blood and tissue typing and disease testing. In addition, there may be other tests you'll need to undergo before you are a transplant candidate. For example, tests for heart and lung function, cancer screenings, and other evaluations may all be required depending on your particular circumstances.
Once all your tests are performed, the transplantation team will meet to review the results and make a decision on whether you're medically eligible to undergo transplantation. Some medical conditions, such as severe uncorrectable heart disease, recent cancer (other than basal cell skin cancer), and other conditions that may pose high risk of death during the immediate transplant period will prevent you from being deemed medically eligible for transplantation.
When you are determined to be eligible for surgery, you'll be placed on a “wait list” for a compatible organ. During this time, you will continue to be treated by your referring physician for your underlying illnesses. The transplant team will be working cooperatively with your physician, as needed, during the wait period. Wait time is significantly shorter for those patients who have a compatible living donor.
Once a compatible organ is available for transplantation, you'll be contacted by one of your team members. During the surgical and post-surgical periods, the transplant team will continue its coordinated approach to meeting your needs.
Patients are considered for transplantation if they have actual or impending kidney failure. Patients are evaluated on an individual basis by our team of transplant physicians and surgeons to determine if they are medically eligible for surgery.
In most cases, kidney transplantation is the most important life-saving medical option available to patients with end-stage renal disease (ESRD). Many patients have been ill for a number of years prior to transplantation and enjoy a significantly enhanced quality of life after surgery; they no longer need dialysis, have more energy, and can eat a less restricted diet.
Due to advances in immunosuppression and surgical techniques, pancreas transplantation has become a viable treatment for patients with insulin-dependent diabetes. Patients who are evaluated for pancreas transplantation undergo a similar process to that of kidney transplant candidates. The primary benefit of the pancreas transplant is that a functional pancreas provides a correction of the patient’s blood glucose levels, allowing the patient to be removed from insulin therapy and a liberalization of his/her diet, improving quality of life and halting the progression of secondary diabetic complications.
Kidney/Pancreas Combination Transplants
Although kidney and pancreas transplants have gained widespread acceptance in the United States, HackensackUMC is one of only a small number of facilities in New Jersey and the region to be certified to perform kidney/pancreas combination transplants. Kidney/pancreas procedures were developed with the goal of giving diabetics freedom from the use of insulin and dialysis, improving quality of life and halting the progression of secondary diabetic complications.
Traditionally, donated organs came from deceased individuals who, prior to death, had indicated their desire to help others through the donation of organs or whose family members made the generous gift of life upon the death of their loved one.
Organs from deceased donors come from a nationwide organ distribution system know as the Organ Procurement and Transplantation Network (OPTN), which is operated by the United Network for Organ Sharing (UNOS), an independent nonprofit organization. UNOS maintains a database of eligible transplant patients awaiting organs and establishes the policies that determine which organs are offered to potential recipients across the country.
Because of the large number of people across the country awaiting organs, it can take 3-5 years (or longer) for a compatible donor match to be available for any given individual. The waiting time differs in each region of the country; in New Jersey the median time is approximately 4.5 years.
Increasingly, kidney transplantation is being done with organs donated by individuals who are still living. This donation can be done for a specific individual or in what is known as a “paired exchange”. During your evaluation and while on the “wait list”, your transplant team members will talk with you about living donor possibilities. Should a possible living donor be available, he or she will undergo a similar evaluation and receive similar support services as the potential organ recipient. In addition, the potential donor will be assigned a Living Donor Advocate who will assist them with additional issues they may face.
A kidney from a living donor offers important advantages over kidneys from a deceased donor, including a lower chance of rejection and the convenience of planning and scheduling the transplant for when the timing is best for you and your donor. This might allow you to avoid the need to ever begin dialysis treatments, or, if you have already begun dialysis, it will shorten time that you need to continue treatments from waiting for years for a deceased donor transplant to waiting a few months. The donor may or may not be related to you by blood. So, while a family member (parent, sibling, cousin, etc.) may be a compatible and willing donor, so too, can a spouse or friend.