University of Pennsylvania Health System

Liver Transplant Update | Penn Medicine

Tuesday, June 30, 2015

Help Those Considering a Liver Transplant: Share Your Story

At Penn, we are committed to helping patients build an effective community of support, that complements the care we give, with different types of practical help throughout the transplant process.

That’s why we offer a special feature on the blog called “Share Your Story.”

While patients and their caregivers receive ongoing clinical and social work support from our team, one additional meaningful source of support patients tell us they’ve received comes from connecting with people who have already been through the liver transplant process.
While this connection often happens at the Liver Transplant Support Group, not everyone can attend the meetings. To help connect our patients who are waiting for livers to become available with people who had successful liver transplants, we offer a regular feature called “Share Your Story”.

If you are a post-transplant patient or support person who would like to share a few encouraging pointers for those who are waiting and their support people, we’d love to hear from you.

You can email your story to Transplant Outreach Coordinator, Margaret Leid at margaret.leid@uphs.upenn.edu.

If you have a story to tell but writing isn’t something you love to do, contact Margaret at 215-298-3929 and she can work together with you to capture your story in writing.

We look forward to sharing these stories soon!

Friday, June 19, 2015

Maria Molina, MSN, CRNP, Receives International Nursing Excellence Award

The International Transplant Nursing Society (ITNS) announced the recipient of this year’s Nursing Excellence Award: our Penn colleague, heart transplant nurse practitioner, Maria Molina!

This special recognition is awarded annually and honors the unique role that transplant nurses play throughout the complex and often challenging continuum of care required for a successful transplant.

Maria was selected because her career exemplifies the ITNS mission of promoting excellence in transplant clinical nursing. Nominations for Maria to receive this prestigious award highlighted her dedication to patient care, education and research, as well as her outstanding leadership qualities. One nomination from a colleague praised her vision of developing methods to synthesize theories in ways that are most useful to practice and guiding clinical outcomes.

In addition to providing excellent patient care for heart transplant patients at Penn, Maria has worked in collaboration with the American Nursing Association, the American Association of Nurse Practitioners and the American Association of Critical Care to develop guidelines that shape cardiovascular nursing practice in the United States.

Donna Chojnowski MSN, CRNP, director of Clinical Operations Advanced Cardiac Care at the Penn Heart and Vascular Center praised the ITNS for recognizing Maria’s accomplishments and contributions.

“Despite the full-time challenges of her role as a transplant nurse practitioner, and the rigor required to maintain clinical expertise, Maria has made significant educational and research strides,” says Donna. “These ongoing accomplishments identify Maria as a leader in transplant nursing.”

Over the course of her career, Maria has contributed to more than 30 research abstracts. This year, she submitted research that garnered the ITNS 2015 Best Research Abstract Award. In addition to these important personal accomplishments, she currently serves as a resource for transplant nurses throughout the greater Philadelphia area in her role as the director of Professional Development for the Delaware Valley Chapter of the ITNS.

Congratulations, Nurse Molina, and best of luck in your future endeavors. We are so proud of you!

Friday, June 5, 2015

Gift of Life Donor Program: New Transplant National Record


Please join Penn Medicine and the Penn Transplant Institute as we take a moment to celebrate the impressive work of Gift of Life Donor Program that lead their achievement of a new national record in organ donation and transplantation last month.

Thanks to the compassion and generosity of 52 people in our region who said “yes” to organ donation, Gift of Life Donor Program was able to facilitate the transplantation of 152 life-saving organs during the month of May. In the United States, this is the highest number of transplants ever coordinated in one month by an organ procurement organization within its own region.

In addition to this impressive milestone, Gift of Life managed and coordinated an additional 33 transplants from organs that came from donors outside of the Greater Philadelphia region, bringing the total number of transplants coordinated in our region for one month to 185.

This hard work and commitment of the Gift of Life staff, and strong partnership with all the transplant teams throughout our region, resulted in a total of 78 kidneys becoming available for transplantation, 44 livers, 19 hearts, 40 lungs* and four pancreas. To add to this remarkable success, the bone, muscle and tissue that was recovered from 108 tissue donors during May will improve thousands of lives.

Congratulations Gift of Life Donor Program and thank you for your outstanding advocacy and excellent results.

*Lungs are counted individually by Gift of Life, so a bilateral lung transplant is reported as two lungs placed.

Thursday, May 28, 2015

Tips for Liver Transplant Recipients to Stay Safe in the Sun

Summer is on its way, along with plenty of sunshine. Even now as spring gets into full swing, it's important to practice good sun protection while outdoors to prevent skin cancers, such as melanoma. To be well protected, the goal is not to get a sunburn or even a tan.

For liver transplant recipients, not only is it important, it’s critical to take skin health seriously and partner with your healthcare providers to protect yourself. You should take every step you can to minimize your risk.

The reason that careful attention to skin is so serious for transplant patients is because some of the medications prescribed to protect a transplanted liver increase your risk for developing skin cancer. This is particularly true for anyone who has ever had sunburn.

While people with fair skin and light colored eyes are at a higher risk, those with darker skin tones are still vulnerable to skin cancer. Take an active role in this part of your healthcare by practicing early detection and skin cancer prevention.

Protecting yourself from the sun throughout the year is easy to add into your daily routine. By simply wearing protective clothing, such as a wide-brimmed hat, sunglasses and long sleeves, and applying sunscreen with an SPF of 15 or above every couple hours, you can protect your skin from sun-related skin damage. It’s also wise to avoid midday sun between 10am to 2 pm.

In addition to these sun smarts, the Penn Liver Transplant team strongly encourages its patients to see a dermatologist within the first six months following their transplant and once a year after the initial appointment. A dermatologist is specially trained to evaluate and treat disorders of the skin, including infections, rashes and skin cancer. Penn dermatologists offer special expertise in treating post-transplant patients and managing their increased risks.

If you have questions about staying safe in the sun, call your Penn Lung Transplant coordinator or use the “Contact Your Care Team Button” in the MyPennMedicine online portal.



Thursday, May 7, 2015

Update on the 20th Anniversary DASH for Organ Donor Awareness

Thanks to Team Penn Medicine, and the 12,000 people who participated in the 2015 DASH for Organ Donor Awareness. The event was an incredible success.

We’re waiting on the final numbers but the preliminary reports are indicating that the 2015 Dash raised $563, 380! Congratulations to Team Penn Medicine for being more than 175 people strong and raising more than $10,000.00.

As with every event, there are things that go well and opportunities to improve. We’d love to learn what you thought about the event day and what ideas you may have for what Team Penn Medicine can do next year to improve your experience at the Dash.

It would be really helpful if you could take a five-question survey, which should only take three minutes to complete. At the end of the survey you'll have a chance to volunteer for a new Team Penn Medicine Planning Committee, so you can be part of the process to make the Dash a little better next year.

We’ll summarize the survey results and post them to the blog the first week of June. Please take the survey before it closes at 5:00 p.m. on Sunday, May 31.

Thursday, March 26, 2015

Do Prescription Drugs Lead to Liver Failure?

Many people believe that prescription medications are one of the main causes of liver failure. After all, according to the Food and Drug Administration (FDA), drug-induced liver injury (or hepatotoxicity) is the second most common reason drugs are withdrawn from the market.

Infectious disease specialist, Vincent Lo Re, MD, MSCE, and director of the Living Liver Donor Transplant program, David Goldberg, MD, MSCE, set out to uncover the prevalence and outcomes of drug-induced acute liver failure in the United States.

Through their study, Dr. Lo Re and Dr. Goldberg determined that prescription drug-induced liver failure is pretty rare. It’s actually over-the-counter medications and dietary or herbal supplements that most commonly lead to liver failure.

The Study

Dr. Lo Re
To discover the true cause of acute liver failure, the hepatologists and their team analyzed data from an integrated healthcare system, representative of the broader U.S. population. The data they looked at was from Kaiser Permanente Northern California between January 1, 2004 and December 31, 2010.

Among the 5,484,224 patients evaluated, 62 were identified with acute liver failure, nearly half of which were drug-induced. Acetaminophen was associated with 56 percent of cases, dietary and herbal supplements with 19 percent, antibiotics with six percent and miscellaneous medications with 18 percent.

What This Means

Dr. Goldberg
According to Dr. Lo Re, these findings give reason to consider additional regulatory oversight of dietary supplements and herbal products. In particular, acetaminophen (when unintentionally overdosed) often causes acute liver failure.

“These data are reassuring in that they demonstrate that the risk of liver failure, the most dreaded complication from medication-induced liver failure, is a rare event. However, people should still be vigilant about the potential risks of medications and/or supplements, especially for those over-the-counter products that have limited to no proven efficacy.”

If you’ve had liver failure, you know how challenging it can be. Share with your family and friends that they need to be careful about over-the-counter medications and supplements – and amounts –that they choose to take. Make sure to take medications as indicated.


Thursday, March 12, 2015

How to Reduce Sugar in Your Diet

Following transplant surgery, you need to be extra careful with your diet and follow the nutrition guidelines provided by your Transplant dietitian and medical team. In general, nutrition recommendations after transplant include a well-balanced, portion and carbohydrate-controlled diet. Carbohydrate-controlled, in particular, means watching your sugar intake...

While always sweet and delicious, consuming large amounts of added sugar can be more than a dental issue. Sugars in their natural form, like those found in fruits and vegetables, are embraced by our body and are broken down appropriately; however, the addition of refined sugar in processed foods has been clearly linked with health complications.

Following a solid nutrition plan and reducing the amount of refined sugar your consume is one way you can work to optimize how well your transplanted organ functions. To help, we have listed a few alternatives to sugar that you can use in your food and drinks that are healthier, yet just as sweet.

Unsweetened Applesauce

For healthier baking, swap out the sugar for applesauce, which contains more nutrients, as well as fiber, and fewer calories for every cup. Just replace the sugar with equal parts applesauce and you're well on your way to a healthier, sweet snack. Remember, for every cup of applesauce used, reduce the amount of liquid in the recipe by one-fourth cup.

Vanilla

Housed in every baking cabinet, vanilla extract can enhance the flavor without the refined sugar. Even though it can't be used as a 1:1 ratio, it still can reduce the amount of added sugar while keeping the same amount of flavor. A perfect, healthy twist for your favorite cookie! Try cutting a few tablespoons of sugar and using half of a teaspoon of vanilla instead.

Yogurt or Greek Yogurt

Yogurt can provide a good sweet option, as some have relatively low sugar. Nutritionists, Tiffany Donahue, RD, LDN, and Katie Stratton, RD, LDN, suggest adding a little powdered cocoa or a sprinkling of cinnamon to plain Greek yogurt for a fun snack.

Reminder: Remember that honey, maple syrup and dried fruit are natural but concentrated sugars, which should be avoided or limited to small quantities. Raw honey should be avoided completely.