The Solid Organ Transplant Center encompasses the Adult and Pediatric Solid Organ Transplant Programs (liver, heart, lung, kidney, and pancreas) and the Adult and Pediatric Mechanical Circulatory Support (VAD) Programs. The liver, kidney, lung, and pediatric heart/lung programs and administrative functions are located on the 2nd floor of UF Health Shands. The adult heart transplant and VAD programs are located on the 1st floor of UF Health Shands in the Nephrology Clinic location. The donor triage and recovery services of the program are contracted and/or are offsite for the Abdominal Programs and for the Heart Program and are supported by Transplant Center Staff. The department consists of administrative and clinical work spaces and conferencing areas, with clinical services being provided by the transplant coordinator or VAD coordinator teams in the appropriate inpatient or outpatient clinical locations. Business hours are Monday-Friday from 0800-1700 with appropriate on-call activities necessary to run a comprehensive organ failure program (i.e. patient call triage, donor organ triage, organ donor recovery, transplant coordination, and diagnosis of VAD-related device issues).
Description of Patient Populations
The Solid Organ Transplant Center provides services to end-stage organ disease patients who are referred for transplant/VAD evaluation from either within UF Health Shands or from the North Florida and surrounding regions. Transplant and VAD coordinators work collaboratively with a team of physicians, social workers, financial counselors, transplant assistants, transplant data and quality specialists and program leadership to provide a comprehensive and protocol driven evaluation consistent with the requirements of the United Network for Organ Sharing and CMS. The Solid Organ Transplant Center exists to provide the following services:
- End stage disease management as appropriate in conjunction with Transplant physicians
- Inpatient and outpatient transplant and VAD evaluation coordination
- Gathering and preparation of clinical documentation/testing to be presented to the relevant Medical Review Board for evaluation of each potential candidate’s acceptability to be listed for transplant or to have a VAD placed
- Ongoing pre-transplant patient management while the patient is awaiting organ transplant
- Continued updating of UNOS waiting lists and other data points utilized for matching donors to recipients and for quality reporting
- Updating of Intermacs VAD registry
- Screening of donor offers for acceptability
- Coordination of organ recovery and admission of the patient for transplantation
- Post-Transplant and post-VAD ongoing patient management per clinical protocols
- Coordination of other assessments needed for transplant or VAD patients (i.e. psychosocial screening, financial screening, access to medications, and so forth)
- Providing all services to patients, donors, referring physicians and internal colleagues in a manner that supports UF Health Shands mission and customer service expectations
- Hospital-based Epic patient care system
- OTTR transplant database
- UNOS UNET system
- Intermacs Registry
- Joint Commission VAD disease-specific certification quality database
- Databases utilized to capture QAPI data
Nursing care is focused on the assessment, diagnosis, planning, treatment, and evaluation of clients requiring end-stage organ disease care focused on those patients who ultimately may need either solid organ replacement or VAD support in both the inpatient and outpatient settings. Nursing activities include: pre-transplant care and screenings, coordination of evaluation testing, assurance of immunizations and other health maintenance needs, coordination of other multi-specialty assessments, development of a comprehensive candidate clinical profile for Medical Review board review, skilled pre- and post-transplant management, and critical thinking skills required to assess donors and coordinate timely transplantation. Client and family education and emotional supports related to the client’s condition and treatment is a vital component of nursing care.
Health Care Team
The Solid Organ Transplant Center utilizes both RNs and advanced registered nurse practitioners in transplant coordinator roles supported by Transplant Assistants. Department management is provided by RNs as Organ-specific Program Managers and an Administrative Director. Each solid organ program (as required by UNOS) and the VAD program have both surgical and medical directors who provide clinical guidance to the leadership and staff. All levels of nurses and physicians provide care within their legal scope of practice and have met department competencies. Nursing staff collaborate with physicians from the UF College of Medicine in the care of each patient.
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