Medical University of South Carolina Transplant Center

Presenters

Rebekkah Wolfe, BSN, RNDr. Carlos Zayas, MD Jodi Schwartz, LISW-CP, CCTSW

Transplant Center Contact Information

MUSC Transplant Center 843-792-5097

MUSC Main Number843-792-2300

MUSC Transplant Fax Number843-876-2968

Clinic Information: 35 Rutledge Ave Charleston SC 29425 9th floor • Valet parking $10, garage

parking $3 and handicap is free

Overview

Introduction: Dr. Carlos Zayas, MD 01

Steps of Transplant Referral/ Evaluation: Rebekkah Wolfe, BSN, RN02

Transplant Social Work Assessment: Jodi Schwartz, LISW-CP, CCTSW03

Why do we Perform Kidney Transplants?

With Transplant Without Transplant

Kidney Transplant Saves Lives

One Year Later…100 Patients with End-Stage Renal Disease

20%will notsurvive

3%will notsurvive

Kidney Transplant Saves Lives

With Transplant Without Transplant

Five Years Later…100 Patients with End-Stage Renal Disease

65%will notsurvive

25%will notsurvive

On average, ESRD patients undergoing renal transplantation live 5+ years longer than ESRD patients who remain on dialysis

Greatest survival advantage seen in PRE-EMPTIVE Transplant recipientsand Living Donor Transplant recipients

Kidney Transplantation: Referral to Transplant

Medical tests Health

Maintenance Homework list

Chart review Contraindications Financial/social

Blood work HLA/PRAs 1093 WL

patients

285 WL patients Transplanted

In South Carolina

“The Darwinian Process” | “The Process”

2 months 4 months5 years

Nationally

Referral

100 pts

Evaluation

55 pts

Selection Committee

32 pts

Waitlist

22 pts

Transplant

12 pts

Overview

Introduction: Dr. Carlos Zayas, MD 01

Steps of Transplant Referral/ Evaluation: Rebekkah Wolfe, BSN, RN02

Transplant Social Work Assessment: Jodi Schwartz, LISW-CP, CCTSW03

Referral to Evaluation: Your Impact!

Present State

Insurance card — front and back

CMS 2728 Form

MUSC Referral Form

What is needed for referral?

Future State

T-Rex: Go- Live 02/2020

Evaluation — 1 Day at MUSCKidney transplant education (video/brief overview with providers)

Multidisciplinary team evaluation

Transplant Surgeon

Transplant Nephrologist

Social Worker

Pharmacist

Dietician

Testing completed at evaluation

Transplant evaluation-specific labs

Chest x-ray

EKG

Echocardiogram

Evaluation to Selection Committee: Homework List

ALL PATIENTS ARE DISCHARGED FROM

CLINIC WITH A HOMEWORK LIST

PATIENTS SHOULD COMPLETE

HOMEWORK LIST IN 90 DAYS

Evaluation to Selection Committee: Your Impact

• Mammogram• PSA• PAP Smear• Others

Health Maintenance

• Stress Test• Echo• Others

Cardiac

• Consults • Patient specific

Everything Else

SELECTION COMMITTEE

Contraindications to Transplant: OBJECTIVE CRITERIA

Age < 64

BMI must be <40

Age > 65

BMI must be <35

Contraindications to Transplant: OBJECTIVE CRITERIA

CDC recommended functional

status testing

Get up and go

Up downs

Functional Status

Transplant Referrals with Potential for Halt

Pre-Screen Process

BMI > 5 points higher

Compromised ambulatory status

Age >75

Mission: Objective, patient centric, and regional patient assessments

SELECTION COMMITTEE

Our Regional Teams

Midlands Region

Misty Chastain, NPKarim Soliman, MD

Kristen, RN and Octavia, TPA

Kaitlin, RN and Todd, TPA

Out of State

Carols Zayas, MD

Lowcountry Region

Aurora Posadas Salas, MD

Tykida, TPA and Michelle, RN

Upstate Region

Zachary Sutton, PAVinaya Rao, MD Sarah, TPA and Rebekkah, RN

Veronica, RN andCrystal, TPA

Florence/ Myrtle Beach Region

Tiffany Tindal, NPMichael Casey, MD

Selection Committee to Waitlist

Chart review

Multidisciplinary Review• Transplant Nephrologist

• Transplant Surgeon

• Transplant Coordinator

• Transplant Social Work

• Behavioral Medicine

• Transplant Financial Coordinator

• Transplant Pharmacist

• Transplant Dietician

Approval to add to UNOS Waitlist

WAITLIST

Overview

Introduction: Dr. Carlos Zayas, MD 01

Steps of Transplant Referral/ Evaluation: Rebekkah Wolfe, BSN, RN02

Transplant Social Work Assessment: Jodi Schwartz, LISW-CP, CCTSW03

Social Work Minimum Criteria

Minimum social work criteria for wait listing

Transportation

Primary Caregiver

Health Literacy

Communication: pick up your phone – We want to reach our patients

Finances: minimum $1000 in savings

Resourcefulness Index

Useful Information from Dialysis Units

Adherence

Mental Health

Substance Abuse

Social Support

Finances

Transportation

Notify transplant team if the psychosocial concerns you have worsen or improve, after transplant evaluation and while patient is on transplant waitlist

*You know your patients best*

How We Can Help You

If patients need assistance or resources, before or after their transplant, with the following, call us!

Mental health resources; brief counseling

Substance abuse treatment resources

Assistance with finances/paying household bills

Health insurance

Job assistance

How You Can Help Us

• Refer the patients (social worker, dietician)

• Encourage referred patients to show up

• Encourage patients to complete their homework

• Provide us your assessment!

• Contact our coordinators

Financial Considerations Transplant benefits: may vary from standard medical/surgical coverage

Rules & regulations of transplant center in relation to finances

• Money set aside for each patient: Deposits, if necessary; Post transplant medications; Travel and lodging

• Patients must inform the transplant financial coordinator of any changes to their insurance status

• Patients need to stay insured

Charities/ Fundraising

• Help, Hope, Live

• National Foundation for Transplants

• Children’s Organ Transplant Association

• National Kidney Foundation