Transplant Center Outcomes 2013

UNIVERSITY OF MICHIGAN TRANSPLANT CENTER

GIVING HOPE NEW LIFE

OUTCOMES 2013

UNIVERSITY OF MICHIGAN TRANSPLANT CENTER

OUTCOMES CONTENTS THE TRANSPLANT CENTER Overview and Volumes . . . . . . . . . . . . . . . . . 2 Quality and Safety . . . . . . . . . . . . . . . . . . . . . 4 ADULT TRANSPLANT Heart . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 Kidney/Pancreas . . . . . . . . . . . . . . . . . . . . . 10 Liver . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14 Lung . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18 ADULT AND PEDIATRIC TRANSPLANT Other Transplantation Services . . . . . . . . . 22 50TH ANNIVERSARY TIMELINE . . . . . . . . . . . 24 PEDIATRIC TRANSPLANT Heart . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26 Kidney . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28 Liver . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30 TRANSPLANT TEAM — IN MEMORIAM . . . . 32 BEYOND THE CENTER Wolverines for Life . . . . . . . . . . . . . . . . . . . 34 Camp Michitanki . . . . . . . . . . . . . . . . . . . . . 36 PHYSICIAN LIAISONS . . . . . . . . . . . . . . . . . . . 38 TRANSPLANT PHARMACY . . . . . . . . . . . . . . . 39 PHYSICIAN LISTING . . . . . . . . . . . . . . . . . . . . 40 LOCATIONS . . . . . . . . . . . . . . . . . . . . . . . . . . . 42

WE ARE THE PEOPLE WHO…

GIVE HOPE NEW LIFE U-M TRANSPLANT CENTER OVERVIEW AND VOLUMES We were there at the beginning from the beginning. A kidney transplant, the first transplant performed at the University of Michigan, was also the first transplant in the state of Michigan.

Between that historical moment in 1964 when our doctors removed a kidney from one sister and transplanted it into her twin all the way to this present moment, our curiosity, determination and ever-growing experience have given hope new life for thousands of patients.

The U-M Transplant Center brings together specialists in adult and pediatric heart, kidney, pancreas, liver and lung transplantation. Additional transplantation services are available through the Kellogg Eye Center and Comprehensive Cancer Center. Survival Flight operates 24 hours a day, 365 days a year and is at the ready to transport donor organs at a moment’s notice.

10,000

OVER ORGAN TRANSPLANT PROCEDURES PERFORMED SINCE 1964

4,138

TOTAL PATIENT VOLUME

(ACTIVELY MANAGED PATIENTS)

11,952

TOTAL PATIENTS

WAIT LISTED SINCE 1995

1,000

OVER PATIENTS ON THE NATIONAL TRANSPLANT WAITING LIST

2

M-LINE 800-962-3555

OUTCOMES More than 200 people participate in the transplant care continuum exclusively, which makes us one of the largest centers in the country. Our experience in taking on complex cases gives families a place to turn when their loved ones are at their most vulnerable, and gives each patient highly individualized specialty care. The Transplant Center’s research provides patients with more treatment options that can delay or even eliminate the need for a transplant, while also advancing the medications and technologies that make safe, effective transplants possible. Our programs train tomorrow’s transplant leaders with mentors who are passionate about educating their newest colleagues. Patients and their families find comfort in the boundless support provided by expert caregivers, peers, and a myriad of activities and events tailored to our transplant community.

Our Wolverines For Life effort has united us with the Michigan Eye-Bank, Be The Match National Marrow Registry, Gift of Life Michigan, the American Red Cross, and numerous other organizations to raise awareness about life-saving organ, blood and tissue donation.

62 TOTAL FACULTY

71 54

40 MEDICAL AND 22 SURGICAL

OVER

200 PEOPLE

WORKING WITH TRANSPLANT CANDIDATES, RECIPIENTS AND LIVING DONORS AT U-M www.UofMHealth.org/Transplant

As we commemorate 50 years of collaboration, innovation and compassionate care, we invite you to review not only the milestones we have achieved but also the excellence of care, state-of-the-art facilities, and gift of hope we can bring to the patients you serve.

CLINICAL TRIALS 1993 – 2009 CLINICAL TRIALS 2010 – PRESENT

OVER

19 MILLION

$

IN CURRENT SPONSORED RESEARCH FUNDING

PARTICIPATED IN THROUGHOUT OUR PROGRAMS

3

SET NEW STANDARDS QUALITY AND SAFETY With more than 400 adult and pediatric transplants performed in 2013, we are committed to providing the highest quality care in the safest environment for every patient. Many people come to the U-M Transplant Center who have been turned away from other centers. We can offer options to this population because of our extensive experience with complex cases and the many specialty services and therapies we offer. Every one of our transplant specialists is dedicated to improving the patient experience at every touch point in the transplant process, whether it occurs in the clinic, operating room or research lab.

SINCE THE UNIVERSITY OF MICHIGAN PERFORMED THE FIRST ORGAN TRANSPLANT

400

MORE THAN ORGAN TRANSPLANTS

70

LIVER TRANSPLANTS IN 2013

PERFORMED IN 2013

40 4

MORE THAN HEART TRANSPLANTS IN 2013

904

LIVER TRANSPLANT PATIENTS RECEIVING POST-TRANSPLANT FOLLOW-UP CARE

239 2,376

KIDNEY TRANSPLANTS IN 2013

KIDNEY TRANSPLANT PATIENTS RECEIVING POST-TRANSPLANT FOLLOW-UP CARE

University of Michigan Transplant Center

OUTCOMES

IN 1964, OUR ORGAN TRANSPLANT PROGRAM HAS GROWN

44

LUNG TRANSPLANTS IN 2013

600

MORE THAN LUNG PATIENTS TRANSPLANTED

www.UofMHealth.org/Transplant

174 PEDIATRIC HEART TRANSPLANTS PERFORMED SINCE OUR PROGRAM BEGAN IN 1984

500

MORE THAN PEDIATRIC KIDNEY TRANSPLANTS PERFORMED

SINCE THE PROGRAM BEGAN IN 1964

900

MORE THAN HEART PATIENTS TRANSPLANTED

5

TRIUMPH OVER COMPLEXITY ADULT HEART TRANSPLANTS Taking care of patients with end-stage heart failure is the sole focus of the Heart Transplant Program.

Our specialists have dedicated their careers to helping people survive with better quality of life and function.

includes adult cardiac transplant surgeons, heart failure and transplant cardiologists with advanced training in transplantation, advanced circulatory support and cardiac critical care specialists, dietitians, and social workers.

We are the leading cardiac transplant center in Michigan. Since 1984, we have performed more than 775 adult heart transplants and have implanted more than 500 ventricular assist devices. Our multidisciplinary transplant team

Our team also works closely with faculty who specialize in congenital heart disease, inherited cardiomyopathies and transplant infectious disease to realize our goal for every patient in the Heart Transplant Program: a return to normalcy.

Alternatives to Transplant With an average of 3,000 patients on the waiting list for a heart each year, the need for alternatives to transplantation is as big an issue as ever. The Heart Transplant Program manages the care of patients on the heart transplant list while exploring viable options to improve their quality of life while they do so. U-M was the first hospital in the state and is one of the largest programs in the country for left ventricular assist device (LVAD) procedures through our Center for Circulatory Support. Patients may also receive oral heart failure medications or intravenous inotropes to help delay the need for transplant.

Options for Combination Transplant Patients Our Heart Transplant Program is highly experienced in combination heart/kidney transplants or heart/liver transplants, so patients with complex health conditions can be offered multiple transplant listings.

Heart Transplant Research Studies As a leading site for many clinical trials that investigate mechanical circulatory support and LVADs, we offer patients the latest treatment options while they are waiting for a heart.

REVIVE-IT is a study led by the University of Michigan and the University of Pittsburgh that is designed to examine the safety and efficacy of implanting LVADs in patients with less advanced stages of heart failure and test to see if the

6

M-LINE 800-962-3555

OUTCOMES The U-M Cardiac Transplant Program boasts a 91% three year post transplant survival rate, compared to an expected survival of 79%.

We have performed more than 775 adult heart transplants to date.

complications that are present in end-stage patients can be averted when the device is implanted earlier in the disease process. National Heart Lung and Blood Institute of the National Institutes of Health and Thoratec Corporation co-sponsor this study.

88%

Educating Tomorrow’s Heart Transplant Leaders The Department of Cardiac Surgery in conjunction with the Section of General Thoracic Surgery adopted a new approach to the training of residents last year. The streamlined program consists of a six-year integrated surgical residency with doctors entering cardiothoracic (CT) residency directly out of medical school.

The program allows surgeons to have more time with the trainees, which gives them more exposure to this specialty. Residents who complete the six years will be completely trained, competent cardiothoracic surgeons.

AFTER 1 YEAR

91% Scot Cannell

AFTER 3 YEARS

Even with no family history of heart disease, Scot Cannell found himself diagnosed with cardiomyopathy in 2009. After receiving an implantable cardiac defibrillator (ICD) that same year and an LVAD two years later, Scot’s only treatment option became transplantation. His second chance began in the spring of 2012 when his donor heart became available. Scot has been living life to the fullest ever since with his wife, three daughters and the 250 band students he teaches every day.

Read more about Scot’s story at uofmhealthblogs.org/cardiovascular/ new-tune-heart-tranplant/11292/

www.UofMHealth.org/Transplant

7

ADULT HEART TRANSPLANT — CONTINUED Patient State of Origin (2011–2013)

Primary Diagnosis for Transplant • Cardiomyopathy • Cardiomyopathy (Nonischemic) • Cardiomyopathy (Familial) • Cardiomyopathy (Hypertrophic) • Cardiomyopathy (Idiopathic) • Cardiomyopathy (Ischemic) • Cardiomyopathy (Postpartum) • Cardiomyopathy (Restrictive) • Congenital Heart Disease • Coronary Artery Disease • Eisenmenger’s (Ventricular Septal Defect) • Hypoplastic (Left Heart)

Length of Stay (in days) 3 Year Average Median

15.00

110

Total: USA and International

766

TOTAL ADULT HEART TRANSPLANTS

1,100

WAIT LISTED SINCE 1995

PERFORMED 1964 – FEB. 27, 2014

8

University of Michigan Transplant Center

OUTCOMES

www.UofMHealth.org/Transplant 9

PARTNER IN CARE ADULT KIDNEY/PANCREAS TRANSPLANTS access to all of our protocols, and direct access to our nephrologists and surgeons at any time.

Kidney Transplantation Our specialists are experts in treating complex recipients with complicated anatomy, multiple transplants and high medical risk. Our team works closely together in following patients from the initial evaluation through transplantation to reduce complications and promote better outcomes.

Kidney Desensitization Program Desensitization offers a viable option to patients who may otherwise be turned down for transplantation due to high levels of antibodies, which make it more difficult to find an adequate donor and create a higher risk for rejection. Our Kidney Desensitization Program is the only one of its kind in Michigan and Ohio. Our desensitization program has enabled 15 transplants.

Since performing the state’s first kidney transplant in 1964, and as home to one of the most active pancreas transplant programs in the country, everything we do is centered on prolonging and improving the quality of life for patients.

Our multidisciplinary team is comprised of surgeons, nephrologists, social workers, transplant coordinators and transplant research coordinators who review and decide on all transplant listings as a committee. Additional specialists provide expert integrated patient care, including midlevel providers, pharmacists and dietitians as well as faculty from infectious disease, urology, gastroenterology, endocrinology and cardiology.

10

Collaboration occurs at many levels and at all phases of the transplant process, from evaluation day through post-transplant follow-up care.

We offer patients: • State-of-the art desensitization techniques • Surveillance biopsies to identify rejection before it is otherwise evident • Enhanced recovery techniques for living donors • Experience to treat complex surgical candidates, including those with obesity, vascular disease, advanced liver disease and urologic conditions In addition to state-of-the-art care and cutting-edge research for patients, referring physicians have

Paired Kidney Donation Program Paired kidney donation may be an option for patients who are not successful candidates for desensitization. As one of the largest paired donor programs in the country, we utilize organ matching software developed at the University of Michigan to pair living kidney donors to hard-to-match recipients. 48 patients received transplants through Paired Kidney Donation.

Kidney Transplant Biopsies We perform kidney transplant biopsies even if the patient is asymptomatic and laboratory values are stable. By performing a preemptive or protocol biopsy, we can diagnose rejection at a very early stage and not only prevent hospital admissions,

M-LINE 800-962-3555

OUTCOMES but also substantial injury to the transplant.

Biopsies are performed at the time of transplant and during the first year post-transplant at three, six and twelve months. All biopsies are read on the same day they are performed by specialized renal pathologists.

• Assessment and optimization of physical conditioning before and after transplant

Pancreas Transplantation

Patients and their families, along with live donors, are well informed every step of the transplant process with education, support and mentoring groups developed especially for them. With 27 dedicated peer mentors for kidney transplant patients available, everyone receives individualized attention.

Pancreas transplantation is our treatment of choice for patients with type 1 diabetes mellitus. We perform pancreas transplantation simultaneously with a deceased donor kidney transplant, after a kidney transplant, and in some cases, before the native kidneys fail. Our goal is for the patient to derive the greatest benefit in terms of survival and quality of life.

Kidney and Pancreas Transplant Research Studies As a leading center for kidney and pancreas transplantation, we are able to offer patients access to treatments not otherwise available in other programs through our broad-based research efforts.

We are currently investigating:

• How to enhance recovery for living donors

Support for Patients and Their Families

Educating Tomorrow’s Kidney and Pancreas Transplant Leaders Two surgical transplant fellows and one transplant nephrology fellow are trained each year. During these 12 months, their training is focused on kidney transplantation, but also any other type of transplant where kidney disease is present.

These fellows go on to become leaders in their respective fields in our health system and across the country.

• Medications that can reduce injury to kidney transplants

We participate in several continuing medical education courses every year for health care professionals who care for kidney and pancreas transplant candidates and recipients. We also host Explore Transplant’s Dialysis Provider Training for dialysis center staff.

• Improved methods to reduce or eliminate immunosuppression

Visit www.med.umich.edu/intmed/cme/ calendar.htm for the latest course schedules.

• Donor and recipient factors that affect transplant outcomes • New anti-rejection medications

• Prevention and treatment of antibody-mediated rejection

www.UofMHealth.org/Transplant

Janice Ottenbacher On March 30, 1964, Joan Ottenbacher donated one of her kidneys to her sister Janice at the University of Michigan in the state’s first-ever human organ transplant. Janice’s kidney had failed after a bout of pneumonia when they were 15 years old. She lived on dialysis until the momentous transplant two years later.

Both were inspired to choose a career in nursing following their experience at U-M. Their procedure positioned our program to lead many national and international efforts to advance the field of transplantation and make history ever since.

Watch Janice’s video at: www.youtube.com/ watch?v=7N34Rfh0Luw

11

ADULT KIDNEY/PANCREAS TRANSPLANTS — CONTINUED Primary Diagnosis for Transplant: Kidney • Diabetes (Adult Onset — Type 2)

• Glomerulonephritis (Streptococcal)

• Nephropathy (HIV)

• Diabetes (Juvenile Onset — Type 1)

• Nephropathy (IGA)

• Diabetes Mellitus (Type 1)

• Glomerulonephritis (Rapid Progressive) (RPGN)

• Diabetes Mellitus (Type 2)

• Goodpasture’s Syndrome

• Nephropathy (Membranous)

• Acute Tubular Necrosis

• Gout

• Nephropathy (Oxalate)

• Alport’s Syndrome

• Henoch-Schoenlein Purpura

• Nephropathy (Reflux)

• Calcineurin Inhibitor Nephrotoxicity

• Hydronephrosis

• Nephrosclerosis (Malignant Hypertensive)

• Chronic Glomerulosclerosis (Unspecified)

• Hypertensive Nephrosclerosis

• Nephrotic Syndrome

• Congenital Obstructive Uropathy

• Hypoplasia

• Polycystic Kidney

• Cystinosis

• Lithium Toxicity

• Prune Belly Syndrome

• Dysplasia

• Malignant Hypertension

• Pyelonephritis

• Fabry’s Disease

• Medullary Cystic Disease

• Renal Agenesis

• Focal Glomerular Sclerosis (Focal Segmental-FSG)

• Metabolic Disorders

• Renal Artery Stenosis

• Nephritis (Cancer Chemotherapy Induced)

• Renal Cell Carcinoma

• Glomerulonephritis (Chronic)

• Nephritis (Drug-Related Interstitial)

• Retransplant/Graft Failure

• Glomerulonephritis (Chronic) (Unspecified)

• Nephritis (Hereditary)

• Scleroderma

• Glomerulonephritis (Fibrillary)

• Nephritis (Lupus)

• Systemic Lupus (SLE)

• Glomerulonephritis (Membranous)

• Nephrolithiasis

• Trauma

• Glomerulonephritis (Post-Streptococcal)

• Nephropathy (Acquired Obstructive)

• Vasculitis

• Glomerulonephritis (Proliferative)

• Nephropathy (Analgesic)

• Wegener’s Granulomatosis

OUTREACH CLINICS To better serve referring physicians and their patients around Michigan, we have opened several outreach clinics to provide more convenient access.

CURRENT LOCATIONS Kalamazoo • Lansing • Midland • Rochester Hills 12

2,405 5,492

• Nephropathy (Interstitial)

TOTAL PATIENT VOLUME

(ACTIVELY MANAGED PATIENTS)

TOTAL TRANSPLANTS

PERFORMED 1964 – FEB. 27, 2014 University of Michigan Transplant Center

OUTCOMES Primary Diagnosis for Transplant: Pancreas • Diabetes Mellitus (Type 1)

Patient State of Origin (2011–2013): Kidney, Pancreas and Pancreas/Kidney

• Diabetes (Juvenile Onset — Type 1)

Length of Stay (in days): Kidney 3 Year Average 4.00

Median

Length of Stay (in days): Pancreas 3 Year Average 5.00

Median

Length of Stay (in days): Pancreas/Kidney 3 Year Average 6.00

Median

Total: United States

6,775 400

LISTINGS SINCE 1995

PANCREAS TRANSPLANTS

48

PATIENTS

RECEIVED TRANSPLANTS THROUGH PAIRED KIDNEY DONATION

634

15

TRANSPLANTS

THROUGH THE KIDNEY DESENSITIZATION PROGRAM

PERFORMED SINCE 1984 www.UofMHealth.org/Transplant

13

PUSH THE BOUNDARIES ADULT LIVER TRANSPLANTS infectious diseases, endocrinology and dermatology are also available at this site for a comprehensive, patient-friendly experience.

Liver Transplant for Complicated Cases The University of Michigan is one of only 20 programs in the country that offers liver transplant as a treatment for bile duct cancer.

Our team coordinates care with experts from radiation oncology, medical oncology and interventional radiology to administer the complicated multi-modality therapy before transplant.

Liver Cancer

As the original transplant center in Michigan, the Liver Transplant Program is known for our expertise in clinical care and research. We have completed more than 2,000 liver transplants to date, including split liver transplants. We provide multidisciplinary, individualized care to patients and their families, beginning with assigning a specific physician to follow them throughout their care before, during and after transplant.

Each member of the multidisciplinary Liver Transplant Program team is dedicated to transplant patients. Our team communicates regularly with

14

referring physicians throughout the transplant process, partnering in patient care through consultations or specific questions or services.

Liver Transplant Clinic In continuing with the tradition of creating multidisciplinary clinics, we now offer patients the ease and convenience of abdominal transplant care in one location. In addition to clinical services, this new clinic features a phlebotomy lab, ultrasound, pharmacy and some outpatient procedures for liver and kidney transplant patients. Specialists from

The University of Michigan is home to one of the first centers in the country to develop a Multidisciplinary Liver Tumor Program where specialists have expertise in treating both liver cancer and liver transplant patients under one roof. Transplant is effective for some patients with limited size liver cancer. Even without liver failure, transplant may be the best treatment option for them.

Liver Transplant Research Studies Access to investigational medicine offers life-changing results. As a leading liver research center, we are able to offer new therapies to cure Hepatitis C, the number one cause for liver transplants. We were the first center to offer these new treatments, and now we are one of only five centers worldwide with access to a combination of these drugs through clinical trials.

M-LINE 800-962-3555

OUTCOMES Robert Gholston Other current research efforts include: • Studies assessing frailty and overall patient medical condition and strength to develop objective parameters for pre-operative risk assessment • Leading enrollment site for NIH-sponsored Acute Liver Failure Study Group, which has developed blood tests and identified new diagnostic assays.

Educating Tomorrow’s Liver Transplant Leaders We have one of the largest and most respected gastroenterology fellowship programs in the country, training six or seven fellows per year for a three-year fellowship. We also offer highly specialized training in transplant hepatology and transplant surgery for two fellows in each program every year.

Our program leads two continuing medical education courses for community physicians during the year: one is a full day of updates and case-based discussions that are specific to liver transplantation, and the other covers updates about liver disease in general.

Robert Gholston unknowingly contracted hepatitis C through a blood transfusion following a car accident when he was just nine years old. By the time he was in his late fifties, a liver transplant became his only treatment option. However, within six months of his transplant the hepatitis C returned. It was during that time that our Liver Transplant Program offered Robert a new option in the form of an investigational oral drug regimen never tried before. Within four weeks of administering an interferon-free combination therapy of sofosbuvir and daclatasvir, Robert’s serum HCV RNA levels were undetectable and liver biochemistries normalized. After two years, Robert continues to live hepatitis C-free, working, walking five miles a day, spending time with his children and grandchildren, and actively promoting organ donation awareness.

Read more about Robert online at www.med. umich.edu/cic/2013-fall/outofthewoods.html

Support for Patients and Their Families All patients and their families attend an education meeting before the patient is added to the transplant list. Every patient also receives a detailed patient education brochure that explains all aspects of the transplant process.

www.UofMHealth.org/Transplant

ADVANCED HEPATOLOGY OUTREACH CLINIC Saint Mary’s Health Care • Wege Building 310 Lafayette SE, Suite 410 • Grand Rapids, MI 49503 • 616-685-8200

15

ADULT LIVER TRANSPLANTS — CONTINUED Patient State of Origin (2011–2013)

Primary Diagnosis for Transplant • Alagille’s Syndrome • Alpha-1 Antitrypsin Deficiency • Budd-Chiari Syndrome • Carcinoma (Hepatocellular) (Non-Fibrolamellar) • Cholangiocarcinoma (Peripheral) • Cholestatic Syndrome (Unspecified) (Chronic) • Cirrhosis (Alcohol-Related) • Cirrhosis (Cryptogenic) • Cirrhosis (Primary Biliary) • Cirrhosis (Secondary Biliary) • Hepatic Failure (Idiopathic) (Fulminant) • Hepatic Failure (Other Drug Toxicity) (Fulminant) • Hepatic Fibrosis (Congenital) • Hepatitis (Autoimmune Chronic Active) • Hepatitis B Virus Infection (Fulminant) • Hepatitis C Virus Infection (Chronic) • Liver Disease (Other Chronic Drug-Induced) • Non-Alcoholic Steatohepatitis • PSC (No Bowel Disease) • PSC (Ulcerative Colitis) • Sarcoidosis

Total: United States

212

• Sclerosing Cholangitis (Primary) • Wilson’s Disease

Length of Stay (in days) 3 Year Average Median

16

10.00

University of Michigan Transplant Center

OUTCOMES

876

1,700

(ACTIVELY MANAGED PATIENTS)

PERFORMED 1964 – FEB. 27, 2014

TOTAL PATIENT VOLUME

www.UofMHealth.org/Transplant

TOTAL ADULT LIVER TRANSPLANTS

2,630

WAIT LISTED SINCE 1995

17

BRING NEW THERAPIES TO LIFE ADULT LUNG TRANSPLANTS

Collaboration is essential in lung transplantation, and in the Lung Transplant Program at the University of Michigan we work closely together to provide the latest treatment options for patients with end-stage lung disease. Our extensive experience contributes to improved outcomes as demonstrated by our one year survival rate which is higher than the national average.

Our multidisciplinary team includes pulmonologists, thoracic surgeons, nurses, coordinators, social workers, dietitians, and transplant pharmacists. We also collaborate with experts throughout the various medical specialties in anesthesiology, critical care, infectious disease, cardiology, radiology, pulmonary hypertension, cardiac transplantation, congenital heart disease,

18

rheumatologic and scleroderma lung disease, hepatology, thoracic radiology, and lung pathology.

Dyspnea Clinic All patients referred to our program are seen initially in the specialty Dyspnea Clinic by one of our eight lung transplant physicians where they are evaluated for novel therapies or considered for enrollment in one of our many NIH- or commercially sponsored clinical trials.

Our Dyspnea Clinic offers complete support to pulmonologists throughout the state to treat the full scope of conditions that can result in end-stage lung disease, including:

• Chronic obstructive pulmonary disease (COPD) and emphysema • Pulmonary hypertension • Sarcoidosis

Thoracic Surgery Our section of Thoracic Surgery, composed of six UNOS certified transplant surgeons, are available 24 hours a day to procure and transplant lungs for our waitlisted patients. Their expertise also includes ECMO, EVLP and critical care support.

Lung resection and esophageal surgery round out their focus of interest.

• Pulmonary fibrosis • Cystic fibrosis

M-LINE 800-962-3555

OUTCOMES National Emphysema Treatment Trial (NETT) We were one of 26 centers to provide lung volume reduction surgery (LVRS) for patients with severe emphysema. This study focused on examining the effects of optimal medical management and LVRS on short- and long-term survival, as well as lung function, exercise performance, and quality of life.

Results from this study have led to further investigation on bronchoscopic endobronchial interventions and other techniques less invasive than LVRS to achieve lung reduction.

In the spirit of the NETT trial, which was a NIH sponsored multi-center trial, we are currently one of only five centers participating in the WRAP-IPF trial evaluating the effects of laparoscopic reflux surgery for the treatment of IPF.

Alternatives to Transplant For patients who are not quite ready for transplant or are currently awaiting donor lungs, we offer many alternatives that may delay or defer the need for transplantation.

• Extracorporeal membrane oxygenation (ECMO) • Opportunities for novel therapies through clinical trials

Extracorporeal Membrane Oxygenation (ECMO) We are a leading center for the use and development of technology related to ECMO as a bridge to transplant and to support patients that have graft dysfunction after transplant.

• Participation in the Lung Transplant Outcomes Group (LTOG) that studies primary graft dysfunction

We are one of eleven centers participating in the NOVEL trial looking at the use of XVIVO lung perfusion (EVLP). We will be sharing our expertise and collaborating with Gift of Life Michigan and Henry Ford Health System to offer EVLP in our center as part of an effort to increase the volume of donor lungs available to patients in Michigan.

Other current lung transplant research includes:

These options include: • A variety of medications, which is the most common form of therapy

• Investigating causes and prevention of donor lung injury, specifically primary graft dysfunction

• Supplemental oxygen therapy

• Pathogenesis of chronic rejection of the lung resulting in obliterative bronchiolitis and/or restrictive allograft syndrome

www.UofMHealth.org/Transplant

• Development of an artificial lung

XVIVO Lung Perfusion (EVLP)

• Studying the role of human lung resident mesenchymal stem cells and prostaglandins in the development of fibrosis or chronic rejection of the lung allograft

• Lung volume reduction surgery (LVRS), which improves breathing by removing a portion of damaged lung tissue to help the remaining lung work more efficiently. This option is available only to a small portion of patients with emphysema

• Mechanisms of fibrotic lung disease development in idiopathic and connective tissue diseases

XVIVO Perfusion

• Changes in the transplanted lung “microbiome” or lung microbiologic environment • Gastroesophageal reflux effects on the fibrotic and transplanted lung

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ADULT LUNG TRANSPLANTS — CONTINUED Educating Tomorrow’s Lung Transplant Leaders We currently train five fellows per year in pulmonary and critical care medicine, and two cardiothoracic fellows per year in thoracic surgery who are thoroughly trained in all aspects of thoracic transplantation. Many of our previous fellows are leaders at academic institutions with more than 60% of them in academic medicine.

Our CME Pulmonary and Critical Care Medicine Update course is offered annually and open to all health care providers. We also host on-site outreach events throughout the state as requested.

Support for Patients and Families Under the guidance of our social workers, transplant coordinator, nurse coordinators and pharmacists, we provide personal support for the patient and family members throughout the transplant process. This is supplemented by a personal education class, an educational booklet with a DVD, and online Patient Education Videos.

Our lung transplant support group meets monthly, providing a positive environment for patient education and peer-peer discussion.

Communication is strong between participants who assist in organizing biannual group events.

Jack Wagner and Dan Roy On January 3, 2011, two patients met for the first time as they made transplant history together. Jack Wagner and Dan Roy, both 64 years old and diagnosed with Idiopathic Pulmonary Fibrosis, became our 499th and 500th lung transplant recipients after each received the gift of a lung from the same organ donor almost simultaneously. While a notable

achievement for the specialists in our Lung Transplant Program, even more remarkable are the many more moments Jack and Dan have enjoyed with their families thanks to the generous family of their donor.

1969:

1990:

FIRST REVOLUTIONERY EFFORT AT LUNG TRANSPLANTATION IN MICHGAN 20

Read more about Jack and Dan’s historical day online at www.uofmhealth.org/news/500thlung-transplant-0211

U-M PERFORMED THE STATE’S FIRST LUNG TRANSPLANT

University of Michigan Transplant Center

OUTCOMES 2013 Patient State of Origin (2011–2013)

Primary Diagnosis for Transplant • Alpha 1 Anti-Trypsin Deficiency • Bronchiolitis (Obliterative) • Cystic Fibrosis • Emphysema • Eosinophilic Granuloma (EG) • Graft versus Host Disease with Lung Involvement • Hypersensitivity Pneumonitis • Hypertension (Primary Pulmonary) • Interstitial Pneumonitis • Lymphangioleiomyomatosis • Obstructive Pulmonary Disease (Chronic) (COPD) • Pulmonary Fibrosis • Sarcoidosis • Silicosis And Pulmonary Fibrosis (Occupational)

Length of Stay (in days) 3 Year Average Median

15.00 Total: United States

837

98%

LUNGS TRANSPLANTED

1 YEAR SURVIVAL RATE

INTO 580 PATIENTS BETWEEN 1990 AND DECEMBER 2013

SIGNIFICANTLY HIGHER THAN THE NATIONAL AVERAGE

www.UofMHealth.org/Transplant

89

803

WAIT LISTED SINCE 1995

21

COME TOGETHER FOR COMPLETE CARE OTHER TRANSPLANTATION SERVICES The U-M Transplant Center is one part of a larger collection of transplant services available at the University of Michigan Health System. Adult and pediatric patients in need of blood and marrow or cornea transplants will find expert care and access to the latest research and technologies for these services in our sister centers.

Cornea Transplants As part of their mission to improve lives through curing, preventing, and treating eye disease, the University of Michigan Kellogg Eye Center regularly performs cornea transplants in adult and pediatric patients, including anterior lamellar endothelial keratoplasty. Working in partnership with the Michigan Eye-Bank, the Kellogg Eye Center provides this sight-saving surgery and participates in research, such as advanced techniques for storing donor corneas in fluid for several days to improve surgical outcomes and more flexible scheduling.

For more information, visit www.kellogg.umich.edu

Adult Blood and Marrow Transplants The Blood and Marrow Transplant Program at the University of Michigan is one of many services offered at the Comprehensive Cancer Center, and one of the largest programs in the state with more than 200 procedures performed each year.

A multidisciplinary team of specially trained physicians, nurses, physician assistants and transplant coordinators dedicated to stem cell transplantation provides compassionate, expert

22

Kellogg Eye Center care. Social workers, psychologists, dietitians and patient educators are also available to address the special needs of blood and marrow patients and their families. Adult patients with blood cancers, bone marrow deficiencies and certain immunodeficiency disorders have access to the latest research innovations of this highly specialized treatment through this program.

For more information, visit www.cancer.med.umich.edu/cancertreat/ treatment/bmt

Pediatric Blood and Marrow Transplants The University of Michigan’s C.S. Mott Children’s Hospital is home to the largest and most experienced pediatric blood and marrow transplant program in the state. The Pediatric Blood and Marrow Transplant team includes dedicated physicians and nurses who specialize in the treatment and research of children with cancer, immune system diseases, hemoglobin disorders, other bone marrow diseases, and some metabolic diseases. The program’s success rates

M-LINE 800-962-3555

OUTCOMES 2013

Comprehensive Cancer Center and donor match rates meet, and often exceed, the national averages. C.S. Mott Children’s Hospital is a member of the National Marrow Donor Program and is an active participant in the Children’s Oncology Group.

For more information, visit www.mottchildren.org/medical-services/ peds-bone-marrow-transplant

www.UofMHealth.org/Transplant

C.S. Mott Children’s Hospital

OVER

200

PATIENTS

WITH FAILING EYESIGHT RECEIVE CORNEA TRANSPLANTS AT THE KELLOGG EYE CENTER EACH YEAR

200

OVER ADULTS AND CHILDREN RECEIVE BONE MARROW/STEM CELL TRANSPLANTS VIA THE U-M COMPREHENSIVE CANCER CENTER AND THE PEDIATRIC BLOOD AND BONE MARROW TRANSPLANT PROGRAM EACH YEAR TO BATTLE CANCER AND OTHER CONDITIONS

23

Our Team Was There at the Very Beginning: pushing the boundaries,

daring to dream and giving hope new life for thousands of patients in our state and beyond with the event of a single transplant procedure in 1964. Since then, we have celebrated many firsts, learned from many trials, advanced many techniques, explored many paths, and have trained many new leaders to create transplant programs across the country and around the world.

We are proud of our first 50 years, and even more inspired to build on momentum of this legacy for many years to come.

WE ARE

1964:

1968:

1984:

1985:

The patient and donor were twin sisters who became inspired to start careers in health care after their experience at the University of Michigan. Read more about Janice and Joan Ottenbacher’s story on page 11.

The operation was performed on September 20th this year. The U-M procedure team consisted of 22 doctors, and the operation lasted well into the early morning. The donor heart belonged to a 38-year old male who had recently suffered a stroke.

Read more about our pancreas transplant services on page 10.

Read more about our liver transplant services on page 14.

Early attempts to cure Type 1 Diabetes with Pancreas Transplantation contributed to much greater rates of success today, enabling patients to live their lives free of insulin dependence.

The first liver transplant at the University of Michigan was preformed by Dr. Jeremiah Turcotte. Dr. Turcotte’s career in transplantation surgery spanned over 35 years. He was a true pioneer in the field.

FIRST LIVE DONOR KIDNEY TRANSPLANT

24

FIRST HEART TRANSPLANT IN THE STATE

FIRST PANCREAS TRANSPLANT

FIRST LIVER TRANSPLANT IN THE STATE

E THE PEOPLE WHO DEFINE THE FUTURE AND

1988:

FIRST HEART-LUNG TRANSPLANT This revolutionary procedure is rarely preformed in the United States today, but remains a treatment option for a small number of patients.

1990:

FIRST LUNG AND FIRST REDUCED LIVER TRANSPLANTS Read more about our lung transplant services on page 18.

1996:

FIRST LIVE DONOR LIVER TRANSPLANT The first living donor liver transplant at the Transplant Center was preformed on a five year old boy. His donor, a friend, gave him the gift of life by donating a segment of his liver.

2001:

1,000TH LIVER TRANSPLANT U-M Liver Transplant Program celebrates its 1000th liver transplant.

A milestone for the program that started just 16 years earlier.

HONOR THE PAST — 50 YEARS OF SAVING LIV

2002:

2003:

61-year-old former elementary school teacher Bonnie Besonson becomes 500th heart transplant recipient in February of this year.

The camp started up in August of this year, hosting 42 liver, heart and kidney transplant kids for a week of traditional sleep-away camp experiences under the supervision and care of trained medical staff.

Read more about Camp Michitanki on page 36.

500

TH

HEART TRANSPLANT

CAMP MICHITANKI

2008:

5,000TH KIDNEY TRANSPLANT AND PAIRED KIDNEY EXCHANGE PROGRAM LAUNCHED Our overall organ transplant total reaches 8,000 this year.

The Paired Kidney Exchange Program launched in November of this year, and has since enabled more than 19 patients who would otherwise be ineligible due to blood type or HLA incompatibility to find a kidney transplant match through a computer-based algorithim.

The Michigan Transplant Center receives its fourth consecutive Organ Donation Medal of Honor form the U.S. Department of Health & Human Services for its success in raising organ donation rates.

The UMHS Specialty Pharmacy opens and offers highly specialized, coordinated care for transplant patients 24/7. Read more about the pharmacy on page 39.

VES

2010:

LIVER TRANSPLANT OFFERS NEW OPTION FOR BILE DUCT CANCER University of Michigan introduces liver transplantation as a treatment option for bile duct cancer patients this year, one of the first in the nation approved to do so.

2011:

2013:

U-M transplant surgeons performed the hospitals 499th and 500th lung transplants simultaneously. One organ donor save the lives of two men.

The 2000th liver transplant was performed. No other hospital in Michigan, and only a handful in the country, have reached this milestone. The U-M Liver Transplant Program began in 1985.

499 AND 500 LUNG TRANSPLANTS TH

TH

2,000

TH

LIVER TRANSPLANT

2014:

50TH ANNIVERSARY AND 10,000TH OVERALL ORGAN TRANSPLANTS Our first transplant recipient, Janice Ottenbacher, with her donor twin sister Joan, joins our 50th Anniversary celebration at Crisler Center. Since their transplant in 1964, our overall organ transplant total reached 10,000 this year.

25

CREATE NEW BEGINNINGS PEDIATRIC HEART TRANSPLANTS With low organ rejection and high patient survival rates that rank among the world’s best, our Pediatric Heart Transplant Program offers expertise and experience that give children with congenital heart defects and cardiomyopathies a fighting chance.

Multiple Transplant Listings

Our dedicated, multidisciplinary team includes pediatric cardiac transplant surgeons, transplant cardiologists, social workers, dietitians, transplant coordinators, nurse practitioners, living donor advocates, financial coordinators, pharmacists and clinical researchers. We work together to provide excellent coordinated and comprehensive evaluation, treatment and follow-up care for children from newborn to 18 years old.

Support for Patients and Families

Alternatives to Transplant Our team specializes in the management and treatment of complex congenital heart diseases, which can help some children avoid transplantation altogether. Alternative treatment options include oral medication, intravenous inotropes and heart assist devices.

For children with kidney or liver disease in addition to heart failure, our center offers multiple transplant listings. Our specialists have extensive experience in performing combination transplants such as heart/kidney or heart/liver.

Education and family involvement are very important to the success of our program. Our Pediatric Heart Failure Transplant Team cares for children during their inpatient stay, while our Post-Transplant Coordinators oversee all post-transplant management, including scheduling follow-up biopsies and blood work. Currently we follow 375 adult and 59 pediatric heart patients.

Transition Care We are dedicated to helping every child we transplant prepare for life as a healthy adult with a heart transplant. We start this process as early as possible so that they will learn how to administer their own medications, call for prescriptions and more by the time they reach adolescence.

62

PATIENT VOLUME

Pediatric Heart Transplant Research Studies The Pediatric Heart Transplant Program participates in the testing of the Berlin Heart® Ventricular Assist Device, and we are currently involved with designing the trials for the newest pediatric assist device through the National Institutes of Health, which gives pediatric patients access to newest heart pump technology available.

Our team also participates in a multi-center Pediatric Heart Transplant Study Group that is dedicated to advancing the treatment of children from listing to post transplant.

Educating Tomorrow’s Pediatric Heart Transplant Leaders Faculty mentors train pediatric cardiology fellows throughout a three-year fellowship, included rotations specifically for working with heart transplant patients and research.

173

TOTAL TRANSPLANTS

PERFORMED 1964 – FEB. 27, 2014

(ACTIVELY MANAGED PATIENTS)

26

University of Michigan Transplant Center

OUTCOMES With low organ rejection and high patient survival rates that rank among the world’s best, our Pediatric Heart Transplant Program offers expertise and experience that give children with congenital heart defects and cardiomyopathies a fighting chance.

Multiple Transplant Listings

Our dedicated, multidisciplinary team includes pediatric cardiac transplant surgeons, transplant cardiologists, social workers, dietitians, transplant coordinators, nurse practitioners, living donor advocates, financial coordinators, pharmacists and clinical researchers. We work together to provide excellent coordinated and comprehensive evaluation, treatment and follow-up care for children from newborn to 18 years old.

Support for Patients and Families

Alternatives to Transplant Our team specializes in the management and treatment of complex congenital heart diseases, which can help some children avoid transplantation altogether. Alternative treatment options include oral medication, intravenous inotropes and heart assist devices.

www.UofMHealth.org/Transplant

For children with kidney or liver disease in addition to heart failure, our center offers multiple transplant listings. Our specialists have extensive experience in performing combination transplants such as heart/kidney or heart/liver.

Education and family involvement are very important to the success of our program. Our Pediatric Heart Failure Transplant Team cares for children during their inpatient stay, while our Post-Transplant Coordinators oversee all post-transplant management, including scheduling follow-up biopsies and blood work. Currently we follow 375 adult and 59 pediatric heart patients.

Transition Care We are dedicated to helping every child we transplant prepare for life as a healthy adult with a heart transplant. We start this process as early as possible so that they will learn how to administer their own medications, call for prescriptions and more by the time they reach adolescence.

Pediatric Primary Diagnosis Heart Transplant for Transplant Research Studies • Cardiomyopathy (Familial)

The Pediatric Heart Transplant Program • Cardiomyopathy (Idiopathic) participates in the testing of the Berlin Heart® • Cardiomyopathy (Restrictive) Ventricular Assist Device, and we are currently • Complex Congenital Heart Failure involved with designing the trials for the newest •pediatric Congenital Heart Disease assist device through the National •Institutes Heart Retransplant/Graft Failure of Health, which gives pediatric patients (Coronary Artery Disease) access to newest heart pump technology available. team also (Left participates •Our Hypoplastic Heart) in a multi-center Pediatric Heart Transplant Study Group that is • Myocarditis dedicated to advancing the treatment of children from listing to post transplant.

Educating Tomorrow’s Length of Stay (in days) Pediatric Heart Transplant Leaders

3 Year Average Faculty mentors train pediatric cardiology fellows Median 21.00 throughout a three-year fellowship, included rotations specifically for working with heart transplant patients and research.

27

NEVER GIVE UP PEDIATRIC KIDNEY TRANSPLANTS Caring for children with chronic kidney disease takes an experienced, integrated team of specialists. Through our Pediatric Kidney Transplant Program, children and their families receive expert, compassionate care from our dedicated social workers, dietitians, transplant coordinators, nurse practitioners, nephrologists, surgeons, living donor advocates, financial coordinators, pharmacists and clinical researchers.

Together we have developed the most experienced program in Michigan, especially in the transplantation of children less than two years of age. We also specialize in performing transplants for children who have been turned down by other centers due to complex surgical issues, obesity and sensitization.

Alternatives to Transplant While a kidney transplant may be the best therapy for some patients, other options like hemodialysis and peritoneal dialysis may be a better alternative for others. Our specialists will work with children and their families to determine which treatment option to choose.

561

PATIENT VOLUME

(ACTIVELY MANAGED PATIENTS)

28

91

TOTAL TRANSPLANTS

PERFORMED 1964 – FEB. 27, 2014

M-LINE 800-962-3555

OUTCOMES Desensitization Program

Road to Self-Care

Some children on the kidney transplant waiting list are sensitized. We offer desensitization therapies to help these patients become compatible with donor organs and reduce the potential for organ rejection.

Living with a kidney transplant is a journey that continues into adulthood. To ensure our pediatric patients learn to care for themselves as they grow and go on to live as productive adults, we work with them one-on-one to provide guidance and on how to administer medications, call for prescriptions, schedule testing and more.

Living Kidney Donors Live donors can decrease the waiting time for a kidney transplant. Parents, siblings, other relatives and altruistic donors can be considered for a living kidney donation. Our team is always available to provide confidential counsel and thoroughly answer any and all questions throughout the decision process.

Support for Patients and Families Child Life Specialists and Pediatric Transplant Psychologists provide comprehensive education and counseling throughout the transplant process.

Children are seen weekly in our clinic for the first three months following transplant, and then follow-up visits are scheduled every three or four months. Our team regularly communicates with referring nephrologists and primary care providers at every stage of the process.

www.UofMHealth.org/Transplant

Pediatric Kidney Transplant Research Studies Our research efforts provide our program with access to novel clinical trials and cutting-edge treatments that are not widely available, including desensitization for pediatric patients.

Educating Tomorrow’s Pediatric Kidney Transplant Leaders The Pediatric Nephrology Program encompasses three years of training, including clinical training and direct involvement with 15–20 new pediatric transplant patients per year. A particular strength of this training program is the development of close working relationships with colleagues from within the department and throughout the Health System.

Primary Diagnosis for Transplant • Diabetes Mellitus (Type 1) • Alport’s Syndrome • Chronic Glomerulonephritis (Unspecified) • Congenital Obstructive Uropathy • Dysplasia • Focal Glomerular Sclerosis (Focal Segmental-FSG) • Hereditary Nephritis • Medullary Cystic Disease • Necrosis (Acute Tubular) • Necrosis (Cortical) • Nephropathy (Acquired Obstructive) • Nephropathy (Reflux) • Nephrophthisis • Nephrotic Syndrome • Polycystic Kidney • Prune Belly Syndrome • Wegener’s Granulomatosis

Length of Stay (in days) 3 Year Average Median

9.00

29

TAKE ON ANY CHALLENGE PEDIATRIC LIVER TRANSPLANTS Helping children grow up to be healthy adults is at the center of everything we do. Since 1986, the Pediatric Liver Transplant Program has restored liver function and a better quality of life to children of all ages from about three months to 18 years old. Our multidisciplinary pediatric team includes social workers, dietitians, transplant coordinators, nurse practitioners, hepatologists, surgeons, living donor advocates, financial coordinators, pharmacists and a clinical research team.

We specialize in treating small infants and children with complex conditions, and offer many options that may delay transplantation or prolong life while waiting for a donor liver.

Nutrition Therapy Our dedicated dietitians help children prepare for transplant and reduce the chances of complications afterwards through individual treatment plans that fulfill calorie requirements at every stage of care.

Support for Patients and Families

130

321

(ACTIVELY MANAGED PATIENTS)

PERFORMED 1964 – FEB. 27, 2014

PATIENT VOLUME

30

Children and their families are fully educated about the transplantation process before, during and after the procedure. Our Child Life specialists and Pediatric Transplant Psychologists facilitate open discussions about living with a transplant, answer any questions families may have, and empower children and their parents to be involved in the treatment plan from the beginning.

TOTAL TRANSPLANTS

University of Michigan Transplant Center

OUTCOMES Life After Transplant Once a child has received a transplant, our goal is to ensure an effective transition to self-care in adulthood through careful assessment and supervised education that starts before adolescence. Children receive one-on-one counseling about how to administer their medications, order their prescriptions and more.

Pediatric Liver Transplant Research Studies The Pediatric Liver Transplant Program is actively involved in many clinical and basic research studies in a variety of areas, giving our pediatric patients access to the latest medications, technology and treatment options for end-stage liver failure.

Educating Tomorrow’s Pediatric Liver Transplant Specialists As part of the Four-Year Transplant Hepatology Fellowship Program, fellows who have already completed a three-year ABIM-certified Gastroenterology fellowship will receive an additional year of training focused solely on transplantation, including the care of pediatric patients with acute and chronic liver failure during the perioperative and post transplant period.

Primary Diagnosis for Transplant

Length of Stay (in days)

• Alagille’s Syndrome • Biliary Atresia • Biliary Atresia (Extrahepatic)

3 Year Average Median

17.00

• Cholestatic Syndrome (Unspecified) (Chronic) • Cirrhosis (Cryptogenic) • Cirrhosis (Other) • Citrullinemia • Hepatic Failure (Idiopathic) (Fulminant) • Hepatitis (Neonatal) • Hepatoblastoma • Maple Syrup Urine Disease • Ornithine Transcarbamylase Deficiency • Urea Cycle Deficiency • Wilson’s Disease

www.UofMHealth.org/Transplant

31

JUST A CALL AWAY TRANSPLANT TEAM Every transplant begins with the rapid and safe delivery of donor organs. As part of the U-M Transplant Center team, we count on the dedicated crew of the Survival Flight fleet to transport our organ recovery teams.

The Survival Flight team includes cross-trained flight nurses, pilots, mechanics and communications specialists who work around the clock to provide highly specialized care to critically ill or injured pediatric and adult patients, and ensure that donor organs are specially handled.

Three American Eurocopter 155 helicopters, along with a Citation Encore fixed-wing plane for longer distances, make up the Survival Flight fleet.

With longer-range capabilities, the Survival Flight

helicopters can travel up to 500 miles away without refueling, then return to the helipads at University Hospital, C.S. Mott Children’s Hospital and Von Voigtlander Women’s Hospital or to the Livingston County airport in Howell, just 30 minutes away.

The work we do to give hope new life to transplant patients would not be possible without our colleagues in Survival Flight.

4.5

SINCE SERVICE BEGAN IN1983

150,000

MILES FLOWN

ANNUALLY (APPROXIMATE)

To learn more, visit www.med.umich.edu/survival_flight To request air medical transport, or discuss your patient with an emergency physician or flight nurse call 1-800-822-2233 any time 24 hours, seven days a week.

MILLION MILES FLOWN

OVER

57,000

PATIENTS & DONATED ORGANS TRANSPORTED TO DATE

1

FLIGHT ST MEDICAL SERVICE

IN THE STATE OF MICHIGAN

32

M-LINE 800-962-3555

OUTCOMES

IN MEMORIAM At 5 p.m. on June 4, 2007, six members of the Transplant Team perished when their Cessna jet crashed into Lake Michigan on their return from an organ recovery mission. We will never forget our colleagues who made many transplants possible for our patients and families:

David Ashburn, M.D. Cardiothoracic Surgery Fellow

Richard Chenault II Transplant Donation Specialist

Dennis Hoyes Marlin Air Pilot

Rick LaPensee Transplant Donation Specialist

Bill Serra Marlin Air Pilot

Martinus Spoor, M.D. Cardiac Surgeon

Their tireless service and sacrifice inspire our mission every day. “Rotations� (pictured above), a memorial designed and dedicated in their honor, stands at the entrance of the main hospital as a testament to their life-saving work.

www.UofMHealth.org/Transplant

33

HELP OTHERS LIVE LIFE TO THE FULLEST BEYOND THE CENTER — WOLVERINES FOR LIFE The U-M Transplant Center is proud to be part of a supportive community of partners whose efforts enrich the lives of transplant patients, donors and their families.

Wolverines for Life dedicates its efforts to raising awareness and promoting organ and tissue donation. As a collaboration between the U-M community, the American Red Cross, Be the Match, Gift of Life Michigan, and the Michigan Eye-Bank, Wolverines for Life spearheads special events and educational opportunities throughout the year to help save lives through donation.

Our outreach efforts include spreading the word about the significance of organ, tissue and blood donation by the people who know how critical it is firsthand: our patients. Together we have created a couple of videos that express heartfelt gratitude to donor families for a precious second chance at life.

We invite you to view and share the Thank You video at youtu.be/Y2QACSTXSHw and the My Hero video at www.youtube.com/ watch?v=bzFWUwZF6jc for these personal perspectives on organ donation.

8

DONOR DRIVES HELD IN 2013

BY WOLVERINES FOR LIFE

2,500

TOTAL UNITS

OF BLOOD COLLECTED IN 2013

100,000

OVER

NEW REGISTRANTS IN 2013 A SIGNIFICANT INCREASE FOR ORGAN DONOR REGISTRATION DUE TO THE SECRETARY OF STATE’S POLICY CHANGES IN REGISTRY OFFICES

300

NEW BONE MARROW DONOR REGISTRANTS IN 2013, OUR INAUGURAL YEAR FOR THIS PROGRAM

34

University of Michigan Transplant Center

OUTCOMES BE A HERO AT THE BIG HOUSE 2013 BLOOD DRIVE: LARGEST DRIVE IN

32

YEAR HISTORY

OF BLOOD BATTLE WITH OHIO STATE

318

TOTAL UNITS

OF BLOOD COLLECTED

800

PARTICIPANTS, VOLUNTEERS AND DONORS IN ATTENDANCE AT THE EVENT

www.UofMHealth.org/Transplant

35

LET KIDS BE KIDS BEYOND THE CENTER — CAMP MICHITANKI Founded by the U-M Transplant Center in 2003, Camp Michitanki brings a traditional camping experience to life for children who have received an organ transplant. For six days each summer, 80 children ranging in age from seven to 15 years join in a variety of fun activities with other transplant kids in a medically supervised residential YMCA camp. Camp Michitanki is supported entirely by individual donations and fundraising events.

Vita Redita (“Life Restored”) is the annual gala dinner and auction that benefits the Michigan Transplant Center. The funds raised at this event help to support all of our programs, including research, educational outreach, a patient emergency fund and Camp Michitanki.

36

M-LINE 800-962-3555

OUTCOMES

10

SUMMERS OF FUN

AT CAMP MICHITANKI FOR KIDS WHO HAVE HAD TRANSPLANTS

OVER

3,200

MICHIGAN RESIDENTS WAITING FOR ORGAN TRANSPLANTS

www.UofMHealth.org/Transplant

37

ANSWER YOUR QUESTIONS & ENSURE PATIENTS HAVE WHAT THEY NEED PHYSICIAN LIAISONS The University of Michigan Health System is pleased to offer a Physician Liaison Program dedicated to providing personalized service to community-based physicians, including consultations, education opportunities about the latest treatment options, and current news and events related to transplant care. We are available for on-site meetings in addition to the activities we sponsor at our facilities. Our goal is to improve communication and coordination of care for referring physicians and their patients.

Meet Our Liaisons Stacy M. Brand, MBA, Outreach Manager

Robert Simsick, Physician Liaison

Stacy M. Brand, MBA, works with community-based physicians as well as dialysis centers for the U-M Transplant Center and as a resource for feedback and information. She, along with our transplant physicians, meet with community-based physicians to provide personalized service and understanding of the needs of these physicians and their patients.

Rob Simsick serves as the U-M Digestive Health and Adult Liver Transplant primary liaison, and is available to visit community-based physicians’ practices. He works with individual practices to understand their patient care needs, and shares information on services, treatment options and clinical trials from the many specialty clinics within the Division of Gastroenterology. He can also facilitate outreach opportunities by our clinical faculty.

Stacy works on the Transplant Center’s continuing medical education (CME) programs, patient education materials and other resources for patients and physicians. She also manages the Transplant Center peer mentor program, which trains transplant patients to become peer mentors and connect with patients waiting for or interested in transplantation. Stacy also partners with outside organizations like the National Kidney Foundation of Michigan and Gift of Life Michigan, including Gift of Life’s Minority Organ Tissue Transplant Education Program (MOTTEP), to grow relationships within the community.

If you would like to contact Rob, please call M-LINE at 800.962.3555 or e-mail him directly at rsimsick@umich.edu.

If you would like to contact Stacy, please call M-Line at 800-962-3555 or email her directly at slipson@umich.edu.

38

University of Michigan Transplant Center

OUTCOMES TRANSPLANT SPECIALTY PHARMACY

Transplant recipients require medications for the rest of their lives, including highly specialized treatments. The U-M Transplant Center coordinates care for transplant patients with pharmacists in the University of Michigan Health System Transplant Specialty Pharmacy.

As a one-stop resource for patients, the Transplant Specialty Pharmacy offers a complete range of services throughout the entire treatment process, including: • Mail-order delivery for timely and continuous access to medications.

• Expert transplant prescription knowledge.

• Clinical support in sync with individual treatment plans.

Referring physicians do not need to be located at a U-M Health System facility for patients to benefit from the expert care available at the Transplant Specialty Pharmacy. Patient members may access specialty medications regardless of where their physician is located.

For more information or to enroll a patient with the Transplant Specialty Pharmacy, call 1.866.946.7695.

• Financial counseling and support for navigating insurance coverage complexities.

• Education about medication regimen and side effects.

• Exceptional, personalized service from a dedicated care team.

• Access to an on-call transplant pharmacist 24 hours a day, seven days a week.

www.UofMHealth.org/Transplant

39

UNIVERSITY OF MICHIGAN TRANSPLANT CENTER PHYSICIAN LISTING Heart Transplant Team

Kidney/Pancreas Transplant Team

Liver Transplant Team

Cardiovascular Medicine Keith David Aaronson, M.D.

Nephrology Diane Marie Cibrik, M.D.

Hepatology Frederick K. Askari, M.D., Ph.D.

David B. S. Dyke, M.D.

Yihung Huang, M.D.

Hari Sree Conjeevaram, M.D.

Todd Michael Koelling, M.D.

Alan B. Leichtman, M.D.

Robert John Fontana, M.D.

John Michael Nicklas, M.D.

Abhijit Naik, M.D.

Hellan Kang Kwon, M.D.

Audrey H. Wu, M.D.

Silas Prescod Norman, M.D.

Anna Suk-Fong Lok, M.D.

Ankit Sakhuja, M.D.

Neehar Parikh, M.D.

Milagros Dalgir Samaniego-Picota, M.D.

Mina Kim Rakoski, M.D.

Cardiac Surgery George Michael Deeb, M.D. Jonathan William Haft, M.D. Francis Dominic Pagani, M.D.

Surgery Michael Joseph Englesbe, M.D.

Himanshu Jagdish Patel, M.D.

John C. Magee, M.D.

Matthew Augustin Romano, M.D.

Robert M. Merion, M.D.

Pratima Sharma, M.B.B.S. Grace Li-Chun Su, M.D. Michael Lucas Volk, M.D.

Jeffrey D. Punch, M.D.

Surgery Michael Joseph Englesbe, M.D.

Christopher John Sonnenday, M.D.

John C. Magee, M.D.

Randall Sukhyun Sung, M.D.

Jeffrey D. Punch, M.D.

Theodore Hobart Welling, M.D.

Christopher John Sonnenday, M.D. Randall Sukhyun Sung, M.D. Theodore Hobart Welling, M.D.

40

M-LINE 800-962-3555

OUTCOMES Lung Transplant Team

Pediatric Heart Transplant Team

Pulmonary Diseases Kristy Ann Bauman, M.D.

Cardiac Surgery Edward L. Bove, M.D.

Kevin Michael Chan, M.D.

Ming Si, M.D.

Kevin Robert Flaherty, M.D.

Richard George Ohye, M.D.

Steven Eldon Gay, M.D.

Jennifer Christel Romano, M.D.

Meilan King Han, M.D. Vibha Narad Lama, M.B.B.S., M.S. Tammy Raye Clark Ojo, M.D. Sarah Roark, M.D. Rommel Larracas Sagana, M.D. Thoracic Radiology, Cardiovascular Radiology Ella A. Kazerooni, M.D. Dharshan Raj Vummidi, M.D.

Pediatric Cardiology Dennis C. Crowley, M.D. Robert John Gajarski Jr., M.D. Kurt Robert Schumacher, M.D.

Pediatric Kidney Transplant Team Pediatric Nephrology David Berrey Kershaw, M.D.

General Thoracic Surgery Philip Worthington Carrott, Jr., M.D.

Kera Elizabeth Luckritz, D.O.

Andrew Ching-Hung Chang, M.D.

Karla Willson, N.P.

Jules Lin, M.D. William Robert Lynch, M.D. Rishindra Mamidi Reddy, M.D. Pulmonary Pathology Jeffrey L. Myers, M.D. Amir Lagstein, M.D.

Larysa Tarashevska Wickman, M.D.

Surgery John C. Magee, M.D.

Pediatric Liver Transplant Team Pediatric Gastroenterology Pamela Irene Brown, M.D. Chris John Dickinson, M.D. Maclovio James Lopez, M.D., Ph.D. Surgery John C. Magee, M.D.

www.UofMHealth.org/Transplant

David Berrey Kershaw, M.D. Pediatric Nephrology

41

UNIVERSITY OF MICHIGAN TRANSPLANT CENTER LOCATION A. Alfred Taubman Health Care Center 1500 E. Medical Center Drive Floor 1, Reception G Ann Arbor, MI 48109 734-936-7491 1-800-333-9013

42

University of Michigan Transplant Center

OUTCOMES 2013 Executive Officers of the University of Michigan Health System Michael M.E. Johns Interim Executive Vice President for Medical Affairs James O. Woolliscroft Dean, U-M Medical School Kathleen Potempa Dean, U-M School of Nursing T. Anthony Denton Acting Chief Executive Officer and Chief Operating Officer, U-M Hospitals and Health Centers

To make a referral or speak with one of our specialists, contact M-LINE 24 hours a day, 7 days a week.

M-LINE 800-962-3555 For additional information see the UMHS Health Provider website.

www.med.umich.edu/umhs/health-providers

The Regents of the University of Michigan Mark J. Bernstein Julia Donovan Darlow Laurence B. Deitch Shauna Ryder Diggs Denise Ilitch Andrea Fischer Newman Andrew C. Richner Katherine E. White Mark S. Schlissel (ex officio) The University of Michigan, as an equal opportunity/ affirmative action employer, complies with all applicable federal and state laws regarding nondiscrimination and affirmative action. The University of Michigan is committed to a policy of equal opportunity for all persons and does not discriminate on the basis of race, color, national origin, age, marital status, sex, sexual orientation, gender identity, gender expression, disability, religion, height, weight, or veteran status in employment, educational programs and activities, and admissions. Inquiries or complaints may be addressed to the Senior Director for Institutional Equity, and Title IX/Section 504/ADA Coordinator, Office of Institutional Equity, 2072 Administrative Services Building, Ann Arbor, Michigan 48109-1432, 734-763-0235, TTY 734-647-1388. For other University of Michigan information call 734-764-1817. Š 2014, Regents of the University of Michigan.

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www.UofMHealth.org/Transplant

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A. Alfred Taubman Health Care Center 1500 E. Medical Center Drive Floor 1, Reception G Ann Arbor MI 48109 1-800-333-9013