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Physician Resource

An Update on UVA’s Unique Partnership to Expand Its Pediatric Liver Transplantation Program

At a Glance

  • UVA Children’s Hospital partnered with Children’s Hospital of Pittsburgh of UPMC
  • The partnership has resulted in four pediatric liver transplants since April and four to six more are expected to occur before the end of the year
  • Transplant teams from UVA and Children’s Hospital of Pittsburgh are constantly in contact, evaluating patients before and after the procedure and performing liver transplant surgeries together at UVA
  • An expanded transplant program means more patients will have access to advanced care close to home

Having a child who needs a liver transplant is hard enough. Being forced to take that child far from home for transplantation makes the situation all the more stressful for families. With this in mind, UVA Children’s Hospital formed a partnership with the Children’s Hospital of Pittsburgh of UPMC that is enabling it to dramatically increase the number of pediatric liver transplants it performs in Charlottesville.

“We are always looking for ways to make transplantation more easily accessible to the citizens of the commonwealth,” says Kenneth Brayman, MD, PhD, FACS, division chief of transplant surgery and director of the Charles O. Strickler Transplantation Center, the only comprehensive transplant center in Virginia. “There couldn’t be a better way to expand our pediatric transplantation program than by partnering with Children’s Hospital [of Pittsburgh].”

A Quality Partner
Children’s Hospital of Pittsburgh of UPMC opened the nation’s first comprehensive pediatric transplant center in 1981. Since that time, it has performed more than 1,200 pediatric liver transplants — more than any other center in the United States, according to the United Network for Organ Sharing (UNOS), with patient survival rates consistently higher than national averages. “The expertise and experience that Children’s Hospital brings to pediatric liver transplantation is unequaled anywhere in the country,” Brayman says.

The partnership is considered a win-win for both hospitals. At the same time UVA was investigating ways to expand its pediatric liver transplantation program, Children’s Hospital of Pittsburgh of UPMC was looking for a way to broaden its pool of donated organs to meet growing demand stemming from an increasing number of referrals from outside its UNOS region. Children’s reached out to UVA to inquire about forming an alliance, which is a testament to the quality of transplantation services UVA offers.

As Brayman notes, a partnership of this nature between institutions hundreds of miles apart is novel in transplantation, requiring detailed discussions and exchanges of information at every level. For helping make the partnership a reality, Brayman credits James Nataro, MD, PhD, MBA, director of children’s services at UVA Children’s Hospital; Karin League, associate chief of UVA Children’s Hospital; Robert Teaster, manager of transplant services; fellow surgeons Shawn Pelletier, MD, director of the liver transplant program, and Sara Rasmussen, MD, PhD; as well as Shelly Dean, RN, MSN, PNP, the program’s coordinator. “We traveled to Pittsburgh many times, and the Pittsburgh people came here,” Brayman says. “We both did our due diligence before we signed because we wanted to make sure things would work smoothly for our patients.”

Pediatric patients in Virginia can now be referred directly to UVA or Children’s Hospital of Pittsburgh for transplants performed in Charlottesville. Transplant surgeons, medical specialists and nurses from UVA and Children’s Hospital of Pittsburgh are constantly in contact, evaluating patients before and after the procedure and performing liver transplant surgeries together at UVA.

“There is a high level of learning that takes place on both sides,” Brayman notes. “On our end, we get to work with really experienced liver transplant surgeons who have been doing this for a long time. In addition, our rapidly developing relationship with our Pittsburgh counterparts affects the expertise available at the UVA Children’s Hospital as a whole.”

A Solid Start
Since April, the joint team from UVA and Pittsburgh has performed four transplants, and Brayman expects to complete eight to 10 transplants by the end of its first year. A side effect of the program is that it has increased the number of total transplants that UVA has been able to perform. In three of the four cases, surgeons have been able to transplant the portion of the liver not needed for the child into an adult recipient.

Thirteen-year-old India Johnson of Norfolk, Va., (pictured above) was the first patient to receive a new liver as a result of this partnership. She suffers from two rare genetic diseases that caused her kidneys and liver to fail. India and her mother, Melody Johnson, traveled to Charlottesville for an in-person evaluation with the UVA team and also met with the Children’s Hospital of Pittsburgh of UPMC team via a telemedicine link. India received a new liver and kidney just three months after she first contacted UVA and, today, is doing well.

“We’re honored that India and her family entrusted her care to us and we’re very pleased with her progress so far,” says George V. Mazariegos, MD, director of pediatric transplantation at the Hillman Center for Pediatric Transplantation at Children’s. “She represents the beginning of an important collaboration between our transplant program and our colleagues at UVA. Working together, we plan to greatly enhance this region’s organ transplant capabilities so that families from Virginia can remain close to home and still get the highest level of pediatric transplant care available in the country.”

“India’s transplant experience is a remarkable example of UVA working with partners to provide the highest level of specialty care to the citizens of the commonwealth,” adds Richard P. Shannon, MD, executive vice president for health affairs at UVA.

For more information about referring a patient to UVA Children’s Hospital, contact our Physician Relations team.

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