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Published on December 01, 2010

Hospital Collaboration Brings Liver Transplant Care Closer to Home

 

SIOUX FALLS (Dec. 1, 2010) - The Avera Transplant Institute in Sioux Falls is collaborating with Aurora St. Luke's Medical Center of Milwaukee to provide liver transplants complemented by local pre- and post-transplant care. This program saves patients in the Sioux Falls area from having to spend up to six months at a transplant center many hours away from home.

The Avera Transplant Institute at Avera McKennan Hospital & University Health Center is currently developing its own liver transplant program to add to its long-standing kidney and pancreas transplant programs, as well as bone marrow transplant. In its 17-year history, the Avera Transplant Institute has provided more than 800 solid organ and bone marrow transplants.

In 2007, Avera added the Avera Center for Liver Disease with the state’s only hepatologist. Avera also has two transplant surgeons, and added a second hepatologist this year. In addition, surgeons rotate between Avera and Aurora transplant programs, increasing depth and breadth of transplant surgery experience and coverage.

“We have the specialists and expertise in place to care for virtually any disease of the liver or hepatobiliary system,” said Dr. Tariq Khan, hepatobiliary surgeon with Avera Transplant & Hepatobiliary Surgery and the Avera Center for Liver Disease. All hepatobiliary cases are reviewed at a weekly conference by a multidisciplinary team, including hepatologists, oncologists, pathologists, interventional radiologists and surgeons.

“Many cases can be cared for entirely in Sioux Falls, because not every patient with liver disease needs a liver transplant. And for those patients who do need a liver transplant, we now have a program in collaboration with Milwaukee,” Dr. Khan said.

Dr. Hesham Elgouhari, hepatologist with the Avera Center for Liver Disease, said there are many stages in transplant care. The process begins with pre-transplant evaluation and testing by a multidisciplinary team in Sioux Falls. If the patient is deemed to be a liver transplant candidate, he or she is added to a waiting list, based on a scoring system which determines how urgent the need is.

Because some liver disease is attributed to alcohol addiction, patients in this situation must go through a chemical dependency program to overcome their addiction before receiving a transplant, Dr. Elgouhari said.

After a patient is listed for transplant, medical staff in Milwaukee determine when the patient needs to come to Milwaukee in advance of surgery, and temporary housing is arranged. This is important because the patient needs to be in the city and ready for surgery when an organ offer comes. After surgery, patients are hospitalized until they are well enough to be discharged.

Then, patients can receive their post-transplant care in Sioux Falls, with any needed post-transplant hospitalization at Avera McKennan. If patients choose another transplant center, for example, in Nebraska or Minnesota, they may have to stay there for the complete duration, which could entail up to six months in one stretch, or multiple two-way trips, adding additional disruption to patient and spouse employment and family obligations. Transplant patients have the option of listing at multiple transplant centers in multiple organ procurement regions in order to increase likelihood of receiving an organ in time, and the Avera Center for Liver Disease facilitates patient wishes for listing. 

Dr. Elgouhari says the cooperative arrangement with Milwaukee brings Avera McKennan a step closer to offering its own liver transplant program, and is helping to prepare the Avera Transplant Institute team for that day.

In many cases, liver disease can be treated with medication or surgery, avoiding transplant all together. But it must be detected and treated at an early stage, Dr. Elgouhari said. “When liver disease is suspected, it is important to seek out specialty care in order to get the proper care in a timely way. Liver disease can be very serious and deadly, but it also can be treated and effectively managed.”

For more information, call (605) 322-8535 or toll-free (877) 200-0583.