by Max Marbut
Staff Writer
The bad news is that more people each day are in need of a kidney transplant because of advanced and even end-stage nephritic disease. The good news is that kidney transplants have become one of the most common organ replacement procedures and the long-term outcome is among the most favorable.
Dr. Tom Peters, University of Florida professor of surgery, shared with the Rotary Club of Jacksonville Monday what he called “Kidney Transplant 101.”
Peters said technology has vastly improved since kidney transplants became considered a “routine surgical procedure” in 1963.
“It was dismal,” said Peters. “Out of the first 50 patients, only half were still alive three years after their transplant.”
He arrived in Jacksonville in 1988 following a fellowship in clinical organ transplantation surgery at the University of Colorado and an appointment to the Department of Surgery at the University of Tennessee College of Medicine, where he rose to the rank of tenured professor of surgery.
His challenge when he came to Jacksonville was to establish the area’s first transplant center at Methodist Medical Center.
“When I came here it was the last metropolitan service area with a population of more than 1 million people without a transplant center,” he said. Since then, the center moved to Shands Hospital and almost 900 kidney transplants have been performed. One reason there are so many kidney transplants is because of the success rate of the procedure and the availability of organs from living and deceased donors.
Even so, he said, “There are too many people waiting for not enough organs.”
Peters said only 11 percent of qualified recipients can secure a donor organ, even through the United Network for Organ Sharing, a national organization that matches those in need with suitable donor organs.
Peters said the reason the demand for donor kidneys has risen can be traced to other medical conditions, particularly high blood pressure and diabetes. Both can lead to kidney failure. He said 500,000 people in the country are on dialysis and 90,000 people on the waiting list for a donor kidney.
The trend in treatment for kidney failure has also evolved. While dialysis was the preferred methodology as recently as 20 years ago, transplant has become the preferred protocol based on a cost comparison.
“Kidneys are easy to transplant and it’s more economical than dialysis,” said Peters.
The prognosis also has greatly improved for those who receive new kidneys. Peters said more than 90 percent of transplant recipients survive at least five years after the procedure.
As for the professional satisfaction involved in kidney transplants, Peters said, “It takes about 90 minutes and it’s a joyous operation to perform. It’s about as much fun as surgery gets.”
Steve Bacalis exercised his prerogative as club president to ask the first question.
“Will we be able to successfully transplant our current insurance coverage to government health care?” he asked.
“I’m a doctor, not a politician,” Peters said. Then he said his experience as president of the Duval County Medical Society and his service on the Florida Board of Medicine could count toward credentials in the political arena.
He said he doesn’t believe medical policy should be set other than by doctors.
“I think it will take time to tell,” said Peters. “But there is no question that too many of us have had to turn patients away for reasons we as physicians do not think are right.”
He also said the medical community was divided on the issue of government-mandated universal health care. “The AMA (American Medical Association) supported the bill to make sure we had a place at the table but the American College of Surgeons did not support it,” he said.
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