What Should Patients Look for in an Organ Transplant Center?

Mark Sturdevant, MD, a transplant surgeon with the USC Transplant Institute, lists key differentiators.

An organ transplant is a second chance at life for many. With so much at stake, patients and their families want to know first and foremost that a transplant will be performed by experts in the field at a reputable transplant center.

Organ transplants are performed at specialized transplant centers. At Keck Medicine of USC, transplants are managed by the USC Transplant Institute, with transplant surgeries performed at Keck Hospital of USC. Transplant centers are often concentrated in metropolitan areas. (The USC Transplant Institute also provides advanced heart, liver and lung transplant care and complex hepatobiliary care to patients living in Southern Nevada at its state-of-the-art facility Keck Medicine of USC – Las Vegas.)

Not all transplant centers are alike. Centers can differ in terms of how successfully their patients survive post-transplant, how experienced a center is based on the volume of transplants it performs and the resources a center has to treat highly complex cases.

Mark L. Sturdevant, MD, a transplant surgeon with the USC Transplant Institute specialized in adult and pediatric liver transplantation as well as complex hepatobiliary procedures, advises what patients and their doctors should look for in a transplant center.

SRTR database

The Scientific Registry of Transplant Recipients (SRTR) is a national database of key data about U.S. transplant centers. It is based on data gathered by the Organ Procurement & Transplantation Network. For each transplant center, SRTR compiles metrics on the number of transplants the center performed using organs from deceased donors, the number of transplants the center performed using organs from living organ donors, as well as information about the center’s transplant survival rate, waiting list survival rate and one-year survival rate.

Dr. Sturdevant explains these key metrics. “‘Survival on the Waiting List’ looks at how the center’s patients survive after being added to the waitlist for an organ transplant. ‘Getting a Deceased Donor Transplant Faster’ assesses how quickly patients at the center can receive a transplant with an organ from a deceased donor. The ‘One-Year Survival’ metric refers to patients who are still alive one year after their organ transplant at the center.”

The quality of a transplant center runs deeper than these metrics alone, but the SRTR report is a good starting place when comparing transplant programs.

Dr. Sturdevant reminds everyone to keep in mind that centers that take on the toughest transplant cases also take on the highest risk that transplants may be unsuccessful.

“If a center is only focused on perfect outcomes, they’re going to decline patients who are in need. You want a center to be willing to take on some risk, because otherwise if a center is only focused on getting the very best outcomes, then unfortunately they’re probably not transplanting some of the higher-risk patients, including those who are older or who have comorbidities — and those patients die if they don’t get transplanted,” Dr. Sturdevant says.

Centers that do living-donor organ transplants

Being transplanted with an organ from a living donor has been shown to have numerous benefits, including reduced wait times and potentially healthier organs and higher transplant success rates. But not all transplant centers perform living-donor organ transplants. (Keck Hospital of USC does for kidney transplants and liver transplants.)

Dr. Sturdevant advises looking for a center that provides living-donor organ transplants when possible if a patient is eligible for one. “Living-donor organs allow us to transplant a patient earlier on, when they’re not so ill,” he adds. “Outcomes are better, and there are also some cost advantages to working with a healthy organ.”

Access to advanced organ preservation

In recent years, techniques have progressed to keep donated organs viable for longer until they can be transplanted into a patient. Machine perfusion is one such organ preservation method. It keeps an organ thriving and has thus increased the supply of donated organs available for transplant.

Large transplant centers work with organ procurement organizations that locate and supply donated organs. These organizations may also utilize these advanced methods of organ preservation, which benefits transplant centers and patients alike.

“Our goal is to use every single deceased-donor organ possible by utilizing these machines,” Dr. Sturdevant says.

An efficient transfer center

The transfer team at a transplant center plays a critical role in ensuring patients are expeditiously transferred to a center for treatment.

“You want to be at a center with a very robust transfer center,” Dr. Sturdevant says. “They will get a patient from A to Z in a rapid fashion. If there is a very sick patient on life support — on a dialysis or a ventilator — who may need to immediately travel to the transplant center by helicopter, the transfer center will ensure they get them right into our ICU.”

Other key members of a transplant team include transplant coordinators to guide a patient through evaluation, treatment and follow-up care; transplant physicians such as hepatologists, nephrologists and cardiologists, who work closely with transplant surgeons and the rest of the transplant team to care for a patient before, during and after surgery; financial coordinators to streamline the insurance and billing process; and other support staff such as social workers and transplant pharmacists.

When possible, look for a physician (hepatologist, nephrologist or cardiologist) knowledgeable about the transplant process. They’ll be able to advise when a patient should be admitted for inpatient evaluation to get the transplant process started. These providers are also key in caring for the patient long after their transplant surgery is complete.

“At the USC Transplant Institute and Keck Hospital of USC, we have subspecialists who are at the top of their field in the entire country,” Dr. Sturdevant says. This makes a difference when it comes to providing transplant patients with the most successful outcomes possible.

Ask your doctor for help

Patients should remember that they can also ask their doctor for help in evaluating a transplant center. “If patients find SRTR and other data about any center they’re seriously looking at, they can review the information with their referring doctor, basing their decisions on objective data,” Dr. Sturdevant says.

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