Transplant programs win top federal certification

By Russell Rian 

April 2010

The Centers for Medicare & Medicaid Services (CMS), which handle transplant services administration for the federal government, have certified UT Southwestern’s transplant programs for heart, lung, kidney and liver. This certification ensures broad access for the medical center to the distinctive multidisciplinary approach provided by its nationally recognized experts.

CMS, an agency of the Department of Health & Human Services, oversees Medicare and Medicaid programs and decides whether to cover a program’s services, so certification is a crucial step. In addition, many other insurers base their coverage on the CMS certification.

Dr. Juan Arenas

More than 100,000 people are currently on wait lists for organs, according to the United Network for Organ Sharing.

CMS extended first-time approval for the UT Southwestern University Hospitals’ Liver Transplant Program — created in 2007 with the arrival of Dr. Juan Arenas, chief of surgical transplantation — in addition to recertifying UT Southwestern’s established programs in heart, lung and kidney transplants.

“In order to achieve CMS status, you have to perform a number of transplants over a period of time and have good outcomes and good follow-up. We waited almost two years for that, and we passed with flying colors,” Dr. Arenas said of the achievement. “Now we’re able to see Medicare-covered patients, which is about 15 percent to 20 percent of all liver transplants.”

The program’s team has completed about 30 liver transplants.

What distinguishes UT Southwestern’s programs is having the academic background, the clinical trials and the ability to do basic and translational research, Dr. Arenas said.

“The ability to develop strategies and treatments based on findings in the lab and from daily clinic practices is a real plus,” said Dr. Arenas, surgical director of the Liver Transplant Program.

In addition to assembling a unique team of medical experts for each patient,
UT Southwestern creates specialized teams to help steer patients through the entire process, from financial paperwork to post-surgical care instructions and follow-up. A dedicated coordinator provides each patient a point person to contact who helps identify and resolve any issues and tracks all the moving pieces.

UT Southwestern has experienced medical experts in the full range of related fields, from heart/lung, kidney and liver disease specialists and surgeons to experts in infection control and immunity and rejection medicine.

Surgeons from the medical center, for example, performed Texas’ first kidney transplant and are responsible for a number of innovations that have become nationally accepted practice. Patients from the heart and lung transplant programs have survival rates that consistently exceed national averages and are among the best in the country. Just last year, the surgical transplant team at the hospitals garnered twin awards for its successful efforts to increase organ donation rates.

“There are so many aspects of transplantation medicine – the medicine, the testing, the paperwork. It requires a robust multidisciplinary team effort, but our patients don’t feel that they have to juggle it on their own. Our approach enables us to keep up with all aspects of each case,” said Janel Tedesco, interim director of transplant services at University Hospitals.

Organ transplantation has evolved into a mainstream treatment for many patients in end-stage organ failure thanks to remarkable strides in transplantation technology and pharmacology over the past few decades.

The CMS certification granted to UT Southwestern University Hospitals sets stringent requirements for selecting patients, handling and procuring organs, ensuring patient safety measures, tracking survival and other outcomes, and submitting verification and data in a timely fashion.

“Transplant cases are never simple, so it’s important to have access to experienced experts from every field who are on site and available when you need them,” said Sharon Riley, vice president and chief executive officer for UT Southwestern University Hospitals. “The most important benefit is to the increasing numbers of patients facing end-stage organ failure who need options.”