Making Organ Retrieval More Efficient, Less Costly

From the 2014 Department of Surgery Annual Report

Mid America Transplant ServicesTransplant surgeons M.B. Majella Doyle, MD, and William Chapman, MD, prepare for a donor-organ retrieval procedure in the nation’s first facility dedicated to that purpose. Specialized equipment and staffing yield cheaper, more efficient procedures as compared to hospital-based retrieval.CONTRIBUTIONS TO THE FIELD by Washington University abdominal transplant surgeons at the national, international and regional levels date to the 1960s. Their influence can be seen today in a research study that may lower the costs of organ retrieval.

Liver transplant surgeon M.B. Majella Doyle, MD, was the study’s first author in the American Journal of Transplantation, which found that retrieving organs from donors in a regional stand-alone facility specifically designed for and dedicated to that purpose is more efficient and considerably less costly than hospital-based retrieval. Results were compiled over 10 years at the nation’s first stand-alone organ retrieval facility, built by Mid-America Transplant Services in St. Louis.

“Organ donors often are given low priority in hospitals because of scheduled surgeries or emergency cases,” says the study’s senior author, William Chapman, MD, the Eugene M. Bricker Chair of Surgery and chief of the Section of Transplant Surgery. “With this new dedicated facility, in addition to the cost savings, we rarely encounter delays anymore, making organ donation easier on families who have lost loved ones and on transplant teams because we  can know when donors’ surgeries will take place.”

Recent initiatives, which also include the option of liver transplant for patients with liver cancer, follow a long history of life-saving treatment. In 1963, nine years after the world’s first successful kidney transplant, surgeon William Newton performed Barnes Hospital’s first kidney transplant. A kidney transplant was performed the following year at St. Louis Children’s Hospital, and programs were formally established at both hospitals in the early 1970s.

Charles Anderson, MD, formally established the kidney transplant program at Barnes Hospital, and Gregorio Sicard, MD, who later led the vascular surgery section, was the first transplant surgery fellow in 1977-78. In 1985, Wayne Flye, MD, performed Barnes Hospital’s first liver transplant with Sicard and Anderson assisting, making Barnes the 16th hospital in the world with a dedicated liver transplant program. Flye performed St. Louis Children’s Hospital’s first liver transplant that year.

Over the past decade, the procedure volume in adults has grown to about 230 kidney and more than 100 liver transplants a year, and the section launched a successful pancreas/kidney transplant program at Barnes-Jewish Hospital. A bright future lies ahead, particularly with the release of the drug sofosbuvir, which promises to reduce hepatitis C as a reason for liver transplantation, opening up the procedure for more patients with other types of liver disease.