By Jeff Kelley

If 2020 at VCU Health Hume-Lee Transplant Center was defined by managing the uncertainty of COVID, last year was marked by acceptance of the pandemic — and thriving in the face of it.

“What our team has come to understand is that COVID is a fact of life, and so we keep going instead of becoming paralyzed or distracted by it,” said Dr. Marlon Levy, chair of the Division of Transplant Surgery and director at Hume-Lee.

Overall, it was a record year in total transplants, living-donor gifts and liver recipients. It’s in line with the transplant team’s simple mantra, “Save lives, one transplant at a time.”

Growth led by liver and living donors

Hume-Lee — which consistently ranks among the nation's leading and most surgically advanced transplant programs — performed 494 transplants in 2021, eclipsing the 459 in 2020 and the 434 in 2019. In 2021, Hume-Lee teams transplanted 284 kidneys, 164 livers, 37 hearts, and nine pancreases.

This year, growth was led by liver transplants. This year’s 164 nearly doubled the number in 2019 (87). Among its many innovations that allow for more livers to be transplanted, Hume-Lee has established a unique program to transplant patients who suffer from severe alcoholic hepatitis, a condition that often disqualifies them at other centers. A multidisciplinary VCU Health team is involved in the program, which focuses on treating the entire patient.

“It’s not just physical care, but the behavioral and mental care that comes along with transplantation,” Levy says. “We understand and treat addiction like the disease it is.”

Growth is also thanks to a thriving living-donor program that allows for healthy people to donate a kidney or a portion of their liver to a transplant candidate. “Our live-donor program is strong, and the quality of those organs and the patient survival rate are superb,” Levy said.

Of the 72 living-donor transplants last year, most were kidney and 19 were liver donors. Eight of the kidneys were “swaps.” Swaps occur when a living donor and the intended recipient are incompatible. Instead of turning that living donor away, that person can donate an organ – usually a kidney – to another person waiting for a transplant whose living donor is compatible in your situation. In turn, both intended recipients receive a compatible, lifechanging organ.

We’re here for the most vulnerable

Hume-Lee is a “transplant safety net” for vulnerable populations, dovetailing with VCU Health’s recognition as a safety-net health system. In this role, the center serves disadvantaged populations.

“We live this mission,” Levy said. “We’re a center committed to increasing access to organ transplants for all. That’s what drives our innovation and approaches to patient care. And we do so with compassion.”

That also means leaning into tough-but-necessary discussions around race, ethnicity and organ transplants. Of the 106,000 people on the national transplant waiting list, 60% are an ethic minority, and most are African American. The greatest need? Kidneys. African-Americans are three to four times more likely to experience kidney failure than whites. And Latinos are 1.3 times more likely.

Its mindset and clinical expertise allows Hume-Lee to also take on the tough patients and cases other centers turn down. Or the reason a patient traveled 1,800 miles to VCU for a complex pancreas surgery. 2021 was a record year at Hume-Lee for the TP-IAT procedure, which cures chronic pancreatitis.

Innovating during COVID … with COVID-positive donors

One of the most impactful innovations in recent months has been learning how to accept organs from COVID-positive deceased donors. “They may not have died of COVID, but they were COVID-positive at the time of death,” Levy explained. “Getting donors who have COVID doesn’t happen often, but as this virus embeds itself in our nation, we'll be faced with that circumstance over and over again — so we need to learn how to make the best of it.”

Factors that go into the decision to use COVID-positive organs include the overall health of the donor or their vaccination status. For recipients, certain treatments, such as monoclonal antibodies, may be used. All of which wouldn’t be possible without a dedicated team working to make industry-leading, complex care an everyday occurrence at Hume-Lee.

“We're thrilled with the team and the hard work and dedication that our people have put in,” he said. “It's very, very humbling to be part of this team — much less lead this team. We are an army of passionate, dedicated people saving lives every day.”

Consider the selfless act of living organ donation. VCU Health Hume-Lee Transplant Center is a leader in pioneering living organ donations.

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