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Winter 2017 - Kidney
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Winter 2017 - Kidney

2016: RECORD OF SUCCESSFUL OUTCOMES AMONG BEST IN NATION

As the year 2016 comes into its last few months, the Montefiore Einstein Center for Transplantation continues its record of producing some of the region's and the nation's most successful outcomes for our transplant patients. In July, a report by the national Scientific Registry of Transplant Recipients showed that Montefiore's rate of transplantation for patients on the organ waiting list is significantly higher than the national average as well as other regional transplant centers. Transplant survival rates among our patients are also high with 1-year (93.97 percent) and 3-year (85.02 percent) graft survival rates. Our living donor kidney program remains at an unbeatable performance, with 100 percent 1-year and 95.08 percent 3-year graft survival.

Our success is directly related to the high volume of these procedures we do here. Since 2014, the Montefiore Einstein Center for Transplantation has consistently performed more than 150 kidney transplants annually. Our team performs the highest number of deceased-donor kidney transplants in New York State; only three other programs in New York State perform more than 100 kidney transplants per year. Our pancreas transplant program is also one of the highest volume and best performing in the region with a 100 percent 1-year graft and patient survival rate.

To access the complete program performance report from Montefiore and other centers, visit www.srtr.org. The Montefiore Einstein Center for Transplantation is a designated Center of Excellence among several insurance carriers. Insurance networks that cover our patients include Empire Blue Cross Blue Shield CME, Optum's Commercial Transplant Centers of Excellence Network and Cigna Life Source Transplant Network.

HOPE ACT IN ACTION

Montefiore has now enacted an Institutional Review Board (IRB)-approved clinical transplant protocol that allows patients who are HIV-positive to receive organ transplants from donors who were also HIV-positive. This protocol is possible under the HIV Organ Policy Equity (HOPE) Act—a bill signed by President Obama and regulated by Organ Procurement and Transplantation Network (OPTN) that accepts the organ donations of HIV-positive individuals. .

Prior to the passage of the HOPE Act, federal law prohibited the donation and transplantation of organs from individuals who were HIV-positive, even if those organs were going exclusively to HIV-positive patients. The HOPE Act now enlarges the available organ pool for everyone who is waiting for a transplant, as more than 1,000 people who are HIV-positive can now receive the donated organs of an estimated 500 HIV-positive donors.

The HOPE Act also includes provisions for the ongoing research of HIV-positive to HIV-positive organ transplantation in the United States, including investigations related to super-infection; incidence and severity of opportunistic infections potentially transmitted from donor to recipient; rate of immunologic rejection of the donor organs; and overall quality of life for the organ recipients. The U.S. Secretary of Heath and Human Services and the OPTN will evaluate these study results to continually assess the safety and viability of the new protocol.

The Montefiore AIDS center provides care to more than 2,500 individuals living in the Bronx who have AIDS or who are HIV-positive. The Montefiore Transplant Center has currently more than 30 HIV-positive kidney transplant candidates on the waitlist and another 30 potential candidates currently in evaluation. The application of the HOPE Act protocol will allow Montefiore, using the highest safety standards, to prioritize access to transplantation to our large HIV-positive population, while also rendering meaningful research contributions to the national experience in HIV-to-HIV organ transplantation.

THE MOST DIFFICULT CASES COME HERE FOR CARE

The Montefiore Pediatric Kidney Transplant Program at Montefiore Medical Center has been performing kidney transplants since 1970, which has allowed us to develop the expertise to treat patients who would otherwise not be able to receive a transplant. Hanouf, a 10-year-old energetic girl from Saudi Arabia, is one of them.

Hanouf was suffering from a congenital protein deficiency and was in end stage renal failure when she sought a transplant in Saudi Arabia was told her condition was too difficult to be treated there. She was undergoing dialysis four times a day. So, her family brought her here, to the Pediatric Dialysis Unit--the only dialysis unit specifically dedicated to children in New York—where she came under the care of Nicole Hayde, MD, Medical Director of the Pediatric Kidney Transplant Program and Anna Zolotnitskaya, MD, Medical Director of the Pediatric Dialysis Unit. After undergoing a successful kidney transplant, Hanouf is now doing well and has normal kidney function.

Her story is one of many that set the Pediatric Kidney Transplant Program apart.

MONTEFIORE PRESENTS AT THE AMERICAN TRANSPLANT CONGRESS

In June, Einstein-Montefiore Transplant Program team members joined thousands of other transplant physicians, surgeons, and scientists in Boston for the annual meeting of the American Transplant Congress. The Congress is the nation's most important gathering for the sharing of clinical and basic science research in transplant medicine.

Our team made several presentations of critical work. Most notable were Enver Akalin, MD, Medical Director of Kidney/Pancreas Transplant and his colleague Michelle Lubetzky, who each presented findings from their genetics-based research on organ rejection. In a separate presentation, Dr. Lubetzky discussed a better way to treat kidney transplant patients who have hepatitis C.

Christian Suarez, MD presented on the positive impact of anti-hypertensive medications for kidney transplant patients. Dr. Adriana Colovai, director of Tissue Typing Laboratory, discussed how changes made to the Kidney Allocation System have increased the number of patients now receiving transplant; those patients are doing well, she reported.

Looking ahead, Juan Rocca, MD, Medical Director of Kidney/Pancreas Transplant Program, discussed the current status of the workforce of transplant surgeons and how to face the need for more transplant surgeons in the future.

SUCCESSFUL COLLABORATIONS BENEFIT MORE PATIENTS

Thanks to partnerships with multidisciplinary teams at White Plains Hospital and St John's Riverside in Yonkers, the Einstein-Montefiore Transplant Program has been able to evaluate more than 50 candidates at these medical centers so far this year for liver, kidney and pancreas transplant. Many of these patients have already received a transplant from a living donor or will soon.

With these collaborations, patients can receive their pre-transplant work-up and post-transplant follow up care in their own communities, which is a great benefit and convenience for them.

Nyack Hospital is now joining the Montefiore network of hospitals participating in the transplant evaluation collaboration, facilitating access to this specialized form of treatment in communities throughout the Hudson Valley.

A SUPPORTIVE FAMILY BEFORE, DURING, AND AFTER TRANSPLANT

The Helping Hands Program at Montefiore is a resource network that helps patients navigate and better manage their health and their lives as they go through the transplantation process. Comprised of doctors, nurses, a nutritionist, social workers and administrators, the Helping Hands Program focuses on helping patients meet the challenges that arise during the transplant process by promoting healthy lifestyle changes.

Helping Hands represents what is best about Montefiore, an organic and altruistic approach to meeting the needs of our patients.

Lend your helping hand today. Call Kristin Waller-Donovan at 718-920-6629 or kwaller@montefiore.org to become involved.

NEW TRANSPLANT TEAM MEMBERS

We are proud to announce the addition of two new key team members to the Montefiore Einstein Center for Transplantation as we continue to grow and expand throughout the Hudson Valley:

Attasit Chokechanachaisakul, MD, Assistant Professor of Surgery

Dr. Chokechanachaisakul, an abdominal organ transplant surgeon, was recruited last spring. He is specializes in liver, kidney/pancreas transplantation and living donor surgery. Besides organ transplantation, Dr. Chokechanachaisakul is also interested in robotic surgery, and both complex and minimally invasive hepatobiliary surgery.

Dr. Chokechanachaisakul received his medical degree from Siriraj Medical School at Mahidol University in Bangkok, Thailand. Once in the United States, he completed general surgery residency at St. John Medical Center in Detroit, Michigan followed by a fellowship in minimally invasive and bariatric surgery at Westchester Medical Center New York Medical College in Valhalla, New York and another fellowship in multi-organ transplantation at Northwestern University in Chicago, Illinois.

Helen Rominiecki, RN, MSN, ACNP-BC, Live Donor Transplant Nurse Practitioner

Ms. Rominiecki is an acute care nurse practitioner specializing in abdominal organ transplantation. At Montefiore, she will serve as the live donor transplant nurse practitioner. She also works directly with our referring doctors facilitating referrals for transplant evaluations at our satellite evaluation sites and working up candidates for living donor transplantation.

Ms. Rominiecki received her Bachelor of Science in Nursing from the University of Virginia and a Master of Science in Nursing from Vanderbilt University. She has clinical experience in the fields of emergency medicine, surgical critical care, and more importantly, she has a solid understanding in organ transplantation after working as a transplant nurse practitioner at the MedStar Georgetown Transplant Institute in Washington, D.C. She holds a national board certificate with the American Nurses Credentialing Center (ANCC) as an acute care nurse practitioner.