Terri L. Cummings, MD, Anup M. Patel, MD, Shamkant Mulgaonkar, MD, Chief of the Renal and Pancreas Transplant Division, Francis L. Weng, MD, MSCE, and Anne Pesenson, MD
-- In response to an ever-increasing need for kidney
and pancreas transplantation, the Renal and Pancreas Transplant Program
recently established Associates in Transplant Medicine – a hospital-based physician practice at Saint Barnabas Medical Center in Livingston, N.J.
The new program’s development is a result of the impressive growth of the Transplant Division at Saint Barnabas and expansion of specialty services such as the state’s fist Living Donor Institute. Already one the most active transplant programs in the country, the hospital-based practice will now offer a more cohesive, patient-focused approach for patients throughout the continuum of care.
Forming Associates in Transplantation are four board-certified nephrologists with extensive training in renal and pancreas transplant medicine. Anup M. Patel, MD, and Francis L. Weng, MD, who have been part of the Transplant Physician Service for several years in private practice, will be joined by Terri L. Cummings, MD, and Anne Pesenson, MD.
The Renal and Pancreas Transplant Division of Barnabas Health, located at Newark Beth Israel Medical Center and Saint Barnabas Medical Center in Livingston, N.J., form one of the largest programs among 240 in the country with more than 225 transplant surgeries performed each year, and more than 4,130 since 1968.
Since the program began nearly 40 years ago, it has remained a leader in the field and pioneered a series of medical firsts in New Jersey, among them, the first living donor kidney transplant program, pediatric nephrology and transplantation program, paired kidney exchange and now the program for incompatible transplantation.
In 2006, Saint Barnabas created New Jersey’s first Living Donor Institute to promote living donation as the best transplant option for patients with chronic kidney disease. Through the Institute, our experienced team is able to forge new opportunities for people who want to donate a healthy kidney to someone in need of a kidney transplant. Programs offered include living- and emotionally-related kidney transplantation, living donor kidney exchange program, altruistic living donation and incompatible transplantation.
Associates in Transplant Medicine is located at Saint Barnabas Medical
Center in Livingston, N.J. For more information please
Chief of the Transplant Division for Saint Barnabas Health Care System
Department of Transplant Research at Saint Barnabas Medical Center
All kidney transplant patients are treated with corticosteroids and two other immunosuppressive agents with the exception of a patient who receives a kidney from an identical twin donor. This post transplant management with triple therapy is standard in all transplant centers throughout the United States. Following successful transplant procedure patients must take all three medications for the rest of their life. Long term use of Corticosteroids is associated with a wide range of serious and debilitating side effects that include significant weight gain, development of new onset diabetes mellitus, hypertension, and increased incidence of infections, cataracts, and osteoporosis and Avascular necrosis of joints . Cosmetic changes can be significant and alter patient’s quality of life. Many past attempts at gradually withdrawing steroids after several months following transplantation resulted in unacceptably high incidence rejection episodes and loss of the transplanted kidney at a significantly high rate.
We designed a study utilizing intraoperative infusion of rabbit antithymocyte globulin (r- ATG) and a course of 3 subsequent doses of r- ATG along with high doses of steroids only for that duration. Corticosteroids were discontinued after the fourth day entirely. Patients’ were also prescribed two other immunosuppressants Tacrolimus and Mycophenolate Mofetil.
We have treated 140 patients so far with this regimen since 2003 with excellent results. The rejection rates have been low and graft and patient outcomes are excellent. Interestingly we have noticed several findings that include tremendous patient satisfaction with cosmetic changes, much lower need for antihypertensive medications, very low incidence of new onset diabetes mellitus, decreased infection rates, better lipid control, no weight gain, insignificant incidence of mood changes and no Avascular necrosis. Many other parameters are being monitored especially to evaluate cardiovascular and skeletal benefits of this steroid free regimen. The study is one of the largest and among the very few performed in the country and is being presented at the international/European transplant society meeting in Geneva Switzerland.
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