From a first-of-its-kind transplant to a machine to keep donor organs viable for longer, Johns Hopkins’ Department of Surgery is performing pioneering procedures and continuing to push the boundaries of medical science.
Reporting System Could Reduce National Waitlist for Kidney Transplants
Transplant surgeon Jacqueline Garonzik Wang and research mentor Dorry Segev are developing report cards for transplant centers showing their use of “suboptimal” kidneys, which are from older or hepatitis-infected donors and donors after cardiac death. Despite the positive outcomes of transplanting suboptimal kidneys, utilization rates vary widely among transplant centers nationwide.
The concept is that when surgeons are offered a suboptimal kidney from their local organ procurement organization, information about the organ would be paired with data from the Scientific Registry of Transplant Recipients. The data would show outcomes associated with transplants using organs of similar quality in hopes that the information could help change organ selection behavior and increase the use of suboptimal kidneys to ultimately reduce the number of patients on the transplant waiting list.
A U.S. First: Living Donor HIV-to-HIV Kidney Transplant
A multidisciplinary team led by Dorry Segev, professor of surgery at the Johns Hopkins University School of Medicine, performed a kidney transplant from a donor living with HIV to a recipient also living with HIV for the first time in the U.S. Segev and his colleagues determined that new HIV drugs are safe for the kidney and that those with well-controlled HIV have essentially the same risks as those without and are healthy enough to donate kidneys.
Keeping Organs Viable for Longer
Transplant teams at Johns Hopkins have been exploring ex vivo machine perfusion as a means to expand the donor pool, increase the range of donor hospitals, and gain extra time to determine an organ’s health and performance before a transplant. This process involves continuously pumping blood through the donor organ to keep it warm and more viable for transplant. Shane Ottmann is the principal investigator for the liver transplant team and Errol Bush is leading the lung transplant team to test ex vivo machine perfusion.
$8.4M NIH Grant to Expand Liver Transplant Study
A six-year Johns Hopkins pilot study made the case for giving liver transplants to select patients with alcoholic hepatitis (inflammation of the liver from excessive alcohol use), as opposed to requiring a six-month sobriety period. The study found that the relapse rate among patients who did not have a wait period was identical to those who did, and the rates of transplant function and patient survival were statistically identical. Researchers received an $8.4 million grant from the National Institutes of Health to expand this study.