Early Transplant Evaluation Means More Options and Better Outcomes

As the only comprehensive transplant center in Virginia, UVA Health is dedicated to transplant excellence and innovation. That's why here, patients can find:

• High-quality outcomes: Our transplant success rates meet or exceed the national averages (see how we're doing).
• Ongoing support: Our transplant coordinators work closely with patients to navigate their journey before, during, and after transplantation.
• Deep experience: We've been performing transplants for nearly 60 years, with more than 7,000 transplants performed.
• Living Donor Program: We're committed to finding and caring for living kidney and liver donors and making the process safe and successful for everyone involved.

Yazan Abu Orabi Al-Adwan, MD, a liver, kidney and pancreas transplant surgeon at UVA Health, notes that for patients whose organ disease puts them at risk for organ failure, "Early recognition and timely referral are critical. Patients should be referred as soon as they have progressive organ failure or when they may benefit from a transplant evaluation, not only when transplantation becomes the only remaining option." Here, Al-Adwan shares what referring providers should know about early recognition of organ disease progression and when it makes sense to partner with a specialist.

How Can Providers Support Early Detection of Progressive Organ Failure Leading to Transplant?

It's important to encourage preventive care while identifying progressive organ disease early. Help patients manage diabetes, hypertension, obesity, and liver disease aggressively, and don't hesitate to refer when you see evidence that organ function is steadily declining.

Collaboration between primary care physicians and transplant specialists early on helps everyone. Patients often benefit from transplant evaluation long before they reach end-stage disease. Providers should monitor disease progression closely:

• For kidney disease, progressive decline in kidney function, persistent proteinuria, and recurrent hospitalizations are important warning signs.
• For liver disease, providers should watch for cirrhosis, portal hypertension, recurrent ascites, hepatic encephalopathy, jaundice, and hepatocellular carcinoma.
• In diabetes, patients with brittle diabetes or hypoglycemic unawareness may be candidates for pancreas transplantation.

Early referral allows us to evaluate all available treatment options before patients become too ill.

When Should Providers Refer a Patient to UVA Health’s Transplant Program?

Earlier referrals almost always provide patients with more options and better outcomes.

Many patients are referred later than ideal. We’re happy to evaluate patients early, provide recommendations, and follow them over time until transplantation becomes appropriate.

A transplant evaluation doesn't mean a patient will immediately undergo transplantation. It simply allows us to assess candidacy, optimize their health, educate them, and determine the best timing. 

How Do You Approach Working With Referring Providers and Their Patients?

Referring providers are essential partners in patient care. Collaboration, communication, and accessibility are priorities for our team. We strive to provide timely evaluations, keep referring physicians informed throughout the process, and work together to ensure continuity of care before and after transplantation.

And every patient has a unique story. I begin by listening. It's important to understand the patient's goals, concerns, and expectations. I explain their condition, review all available treatment options, and discuss whether transplantation is appropriate. I want patients to leave their first visit feeling informed, supported, and confident that we have developed a plan together.