Philadelphia VA Medical Center

A special group of Veterans is on the road to a better quality of life thanks to a kidney transplant program at the Philadelphia VA Medical Center.

The program navigates Veterans through the complex process of getting on the transplant list, which can take six months to a year and includes a 37-point checklist.  Dozens of Philadelphia staff contribute by conducting a plethora of tests and consultations to ensure patients are in optimal condition for transplant evaluation.

Right now, 28 Veterans are on the active list while three have already received a donor kidney.  Without a transplant, they would be relegated to a life of dialysis because of their end-stage renal failure diagnosis, with few alternatives.

The first person to go through the Philadelphia VAMC program is Ricky Shafer, an Army Veteran who received a kidney transplant on his 62nd birthday, Nov. 9, 2010.  Mr. Shafer woke up early to go to his regular dialysis appointment, which he received three times a week for four and a half years. But on this special day he received the phone call that would change his life: a kidney was waiting in Pittsburgh. Patients travel to Pittsburgh for the actual procedure, but all pre- and post-operative care is handled by Philadelphia VA Medical Center staff.

Only one month after the procedure, Mr. Shafer already felt the benefits of the transplant.

"Every day I'm feeling my body recovering and getting stronger," he said. As for that whirlwind day, he gives VA health care high grades. "The process worked perfectly, I'd give the hospital an A."

Dialysis provides an artificial replacement for lost kidney function in people with renal failure. Barbara Rensman, nurse practitioner and kidney transplant coordinator, explained the benefits and significance of a transplant over dialysis.

"Most patients are tired after dialysis and only benefit for a day or so,” she said. “The transplant gives them their life back."

Although dialysis can be trying and tiring, Mr. Shafer’s wife said he never complained about the experience. He credits this stoicism to his training as a paratrooper in the 173rd Airborne Brigade.

"The Army taught me things that have stayed with me,” the Vietnam Veteran stated. “You start something, you do it to completion."

In addition to the physical benefit to the patient, over time a transplant actually costs less than dialysis.

"Patients who receive a transplant feel better and live longer because dialysis only replaces about 10 percent of your normal kidney function," said Dr. Joshua Lipschutz, Chief of Renal. “And by three years after transplant, a kidney transplant is more cost-effective than dialysis.”

Dr. Lipschutz acknowledges that there are upfront costs for the surgery and other details, but by three years there is a break-even point and savings compared to the patient remaining on dialysis.

According to team members, the program would never have begun if not for the perseverance and expertise of Ms. Rensman, the nurse practitioner, and Dr. Peter Reese, a transplant nephrolgist and medical director of Philadelphia’s kidney transplant program.

“It was a very anguishing situation for many years,” said Dr. Maria Duran-Guerraty.  “There was nothing programmed, just the dream of making transplant a choice for Philadelphia Veterans.”

By Gail Ziegler