The Medical Center at Bowling Green Joins UK’s Organ Failure and Transplant Network

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By Hilary Brown 
Sixteen years ago, Grant Lewis was diagnosed with IgA nephrothopy, a rare kidney condition that causes inflammation in the kidneys. There’s no cure for it and treatment can only abate the symptoms so much. But Lewis’s kidneys were going to fail – it was just a matter of time. His nephrologist referred him to the UK HealthCare Transplant Center for a kidney transplant.

But first, Lewis needed a donor – and he didn’t have to look far.

“I asked my sister,” he said. “And she was more than willing to be my donor.”

Before the transplant, there were months of tests and screenings to ensure that Lewis’s sister was a compatible match. That meant frequent trips to Lexington from Lewis’s hometown in Bowling Green; his sister made the long drive from her home in London, Kentucky.

The transplant surgery went off without a hitch in December 2018; Lewis spent only two days in the hospital before going home. He returns to Lexington frequently for his follow-up appointments. But the drive from Bowling Green is a long one – two and half hours without traffic. Throughout his screenings and pre-transplant testing, it’s a drive he has had to make many times; he knows just how hard it can be for people in his situation.

Fortunately, now patients in the western part of the state won’t have to make that drive. The Medical Center at Bowling Green joined the University of Kentucky’s Organ Failure and Transplant Network (OFTN), a UK HealthCare initiative focused on providing patients in organ failure with access to state-of-the-art care, including organ transplantation. As a member of the OFTN, The Medical Center has access to clinical education and training, affiliate administration and network support and community outreach and education. Patients and living donors can have their pre-transplants screening done locally.

The goal of OFTN is to optimize the care of patients with advanced kidney, lung, liver and heart failure by providing seamless continuity of care from initial diagnosis through organ transplantation. Kentucky faces some of the highest rates of organ failure and mortality in the country; roughly 1,000 Kentuckians are currently on the waiting list for an organ transplant.

“This will be easier for people in this part of the state, closer to home,” said Lewis. “They wouldn’t have to take off work or drive long distances.”

“Access is a major priority for our patients and with the establishment of a new outreach location in collaboration with the Medical Center, we are meeting this need to help patients stay closer to home, for longer,” said Dr. Roberto Gedaly, director of the UK HealthCare Transplant Center.

September marked the beginning of a monthly transplant clinic established to treat patients with chronic kidney disease and those in need of a kidney transplant. Patients in the western part of the state currently have to travel across state lines or hours outside of their local communities to seek care for such a sub-specialty service.  By collaborating with The Medical Center, the UK Transplant Center is able to treat patients closer to their established care networks.

The network has allowed The Medical Center physicians and staff to deliver highly specialized clinical therapies for adult patients with acute heart and lung conditions, including an advanced treatment called extracorporeal membrane oxygenation (ECMO). This treatment can be used to let the heart or lungs rest and heal, or it may be used to improve a patient’s strength so he or she can be eligible for transplantation. Through this new relationship, UK HealthCare and The Medical Center have worked out protocols which will allow patients to be placed on ECMO in Bowling Green, stabilized, and then transported to UK for complex follow-up care.

“We realized with our growing population and advanced complexity of critical care patients that bringing ECMO to this community offered a new, potentially lifesaving option not previously possible before in this area,” said Jill Payne, Executive Vice President and Chief Nursing Officer of Med Center Health. “This is a natural progression, as well, of our relationship with UK’s OFTN. Our cardiothoracic surgeons have been key leaders at bringing this program to life, which has already impacted several patients of The Medical Center.”  

The UK Transplant Center has experienced unprecedented growth during the last several years to meet the state’s needs for end-stage organ failure management. Referrals are received throughout the state and region Kidney transplants have grown approximately 40% since 2015 and the center is pacing to complete over 120 for 2019. Heart transplants set an all-time record in 2017, and liver transplants hit an all-time record high of 55 in 2018.  

As UK specialists have begun seeing increasing numbers of patients in end-stage organ failure, the need to collaborate with referring physicians around the care of the patient has grown. By working together and developing new models of “shared care,” patients of providers belonging to OFTN can receive care close to home as long as possible while maintaining access to advanced medicine offered at UK HealthCare. Many of UK’s resources and capabilities are not available elsewhere in the state, such as the bridge-to-transplant options available in the UK Gill Heart Institute’s Heart Failure Program.

This collaboration is just the latest example of UK HealthCare and The Medical Center working together to improve the health of Kentuckians. The Medical Center is already a member of both  UK Markey Cancer Center Affiliate Network and UK HealthCare’s Stroke Network, providing access to high-acuity clinical care and educational programs for faculty, staff and patients. Last year, UK’s College of Medicine, Western Kentucky University and The Medical Center broke ground on a new four-year regional medical campus in Bowling Green, increasing opportunities for more students to receive their medical degrees in a state that is facing a physician shortage.

The Organ Failure and Transplant Network is an outgrowth of longstanding relationships UK has forged with Norton Healthcare and Nephrology Associates of Kentuckiana in Louisville. Other OFTN members are the Baptist Health Enterprise and Charleston Area Medical Center in Charleston, West Virginia. Together, these groups are committed to providing state-of-the-art care for patients in heart, lung, liver and kidney failure who require higher level clinical expertise, including organ transplantation.