Transplant Center Cuts Waiting Time For Patients Needing Kidneys

By Andi Atwater

FORT MYERS FL -- Lung transplant survivor Diane Mogensen desperately needed a kidney and, after two years waiting in Illinois, was told the wait would be up to five.

When Robert Slater's first donated kidney failed after nine years, he went back on the list in New York. He waited three years.

Eileen Fenwick of Coral Springs nearly died before doctors discovered it was lupus that shut down her kidneys. She was on the waiting list for a new one in Miami for more than two years.

Today, each is healthy and recovering with new kidneys in less time than they ever imagined. Despite their disparate circumstances, each of these people share one important fact: They found their future nestled in Fort Myers, at southwest Florida's little-known but growing transplant center.

With more than 30 transplants performed this year so far, The Transplant Center at Southwest Florida Regional Medical Center still is small enough to have one of the shortest waiting lists in the country - and that's catching the eye of hopeful patients who can afford to travel to southwest Florida for help.

The center opened in 1990 and, to date, 414 patients have received transplanted kidneys there, at least 65 percent of them from outside Lee County.

"People from all over find out about it and they come here, because the waiting time's so short," said Dave Mainous, director of transplant services. "Smaller centers do just as good a job as larger centers, and we've proven that."

The wait time for a transplant in southwest Florida averages less than seven months, one of the shortest in the country.

After Mogensen, 65, qualified for a kidney last year at Southwest Regional, she waited 12 days before one became available. She and her husband moved from Chicago to Naples in late 2001 to prepare for it.

Slater, 66, of Long Island said after three years doctors there told him the wait looked to be up to seven years. A longtime Sanibel visitor, Slater found out about Southwest's transplant center after undergoing dialysis in Lee County.

He signed up and five days after he qualified last fall, he got his transplant.

"As far as the kidney's concerned, it's amazing - it turned out a perfect match," Slater said. "The whole experience was great. It's hard to explain, but it's like a family down there."

And Fenwick, 55, who has made the two-hour drive from Florida's east coast dozens of times surrounding her transplant in June, happened to hear about Southwest's center from her transplant social worker in Miami while undergoing nauseating dialysis three times a week.

She was added to the list in March and about three months later got the lifesaving operation.

"I didn't know anything about that hospital. I thought you had to go to a big medical center and I was uneasy about it," said Fenwick, who was in line with hundreds of other hopeful patients at the University of Miami's Jackson Memorial Hospital. "But it went so smooth, I felt like I was at the Four Seasons hotel. I would make the two-hour trip to that hospital for anything."

Southwest Regional has a reason to bask in the praise. The Transplant Center has a 100-percent kidney and patient survival rate for the last 21 months, and its long-term survival rates are comparable to the nation's largest transplant centers.

Nationally, according to the U.S. Department of Health & Human Services, kidney recipients lead the one-year patient survival rate for all transplants at more than 95 percent. The national wait-time average is 35 months, according to the Scientific Registry of Transplant Patients.

Officials at Southwest Regional attribute the shorter wait time to both the center's small size and to the highly successful organ procurement program: LifeLink of Southwest Florida.

"If you have a list that doesn't have a lot of patients and if your organ recovery program is good - it's just a numbers thing," Mainous said. "We're not a large transplant program and we don't profess to be, but you can compare our results with anybody."

Kidney transplants are the No. 1 transplant needed in the United States, with more than 54,300 people awaiting the operation. Most donated kidneys come from cadavers, from people who've agreed to donate their organs upon death.

Dr. Gordon Burtch, surgical director of Southwest Regional's transplant center, said the center's small size allows him to be more choosy when it comes to hand-picking organs.

"I'm very selective, because we have such a short waiting list, I don't have to take a marginal donor - a smoker, older, high blood pressure history, that sort of thing - and we'll pass on it," he said.

Perfect matches anywhere in the nation get first right of refusal, but the majority of kidneys donated in southwest Florida stay here. LifeLink reports that last year, 27 organ donors provided 79 organs for transplant, mostly to hospitals in the region.

Collier County, because of long-ago drawn lines, falls under Miami's organ procurement organization - often meaning longer wait times and explaining why, perhaps, 32 percent of Southwest Regional's transplant patients come from the Naples area.

In the southeastern United States, which the Organ Procurement and Transplantation Network lists as Alabama, Arkansas, Florida, Georgia, Louisiana, Mississippi and Puerto Rico, the percentage of patients waiting five years or longer for a transplant is half of those waiting in New York and Vermont.

Florida has 11 transplant centers and five organ procurement organizations, making it one of the best states in the region for transplant wait times. The remaining states have one organ procurement agency, and the next highest number of transplant centers is six in Louisiana.

"Patients in Florida tend to wait less time than patients in other parts of country because our organ recovery efforts are so strong," said Jean Davis, senior vice president of LifeLink's organ procurement operations. "Kidneys are frequently offered locally first and then outside the area."

At a patient cost of about $20,000 a kidney, that's no small matter. The transplant itself, and all the pre- and post-operative consultations, can cost as much as $70,000. Dialysis, on the other hand, costs more than $50,000 a year per patient, hospital officials said.

While doctors at Southwest Regional say they're eager to treat more patients and expand, they admit there is a certain poignancy and pride in being a smaller facility with fewer demands and good outcomes.

"That's why some patients look for programs with shorter waiting times," said Dr. Joel Van Sickler, a nephrologist and medical director of Southwest Regional's transplant center. "One advantage, because it's a smaller program, I'd like to think we give a little more individual attention, simply because we're not doing 150 to 200 transplants."

Long-term success with kidney transplants is directly related to how soon a patient can get an operation, a recent University of Florida study shows. The longer patients on dialysis wait for a kidney transplant once they've developed end-state renal disease, the worse they fare, said Dr. Herwig-Ulf Meier-Kriesche, associate professor of medicine. The study showed that patients who await transplant for two years have a three times greater chance of losing their kidneys than those who wait less than six months.

"Clearly, avoiding long waiting times is one of the key issues of success of a transplant," Meier-Kriesche said. "The longer on dialysis, the poorer the outcomes - but the patient should still get transplanted, as he'll do significantly better as opposed to patients who remain on dialysis."

Copyright © 2003 The Ledger.

This article posted November 5, 2003.