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The Division of Transplantation was developed in 1991. Previously, the activities of transplantation had been within the Division of General Surgery. The Division of Transplantation includes all abdominal organs (liver, pancreas, kidney, and small bowel) and future growth and expansion to cell transplantation such as islet cells is anticipated for patients with insulin-dependent diabetes mellitus. Thoracic organ transplantation (heart, heart/lung, and lung transplantation) resides within the Division of Cardiothoracic Surgery in the Department of Surgery.
All patients are admitted to this Medical Center for renal, pancreas, and liver transplantation. This transplant center serves the entire state of Alabama and in many instances the surrounding states. The organ procurement organization for the state of Alabama is the Alabama Organ Center which is a part of the University of Alabama Health Services Foundation and the Department of Surgery. Dr. Diethelm is the Medical Director. This Organ Center procures, preserves, and transports cadaveric organs obtained in the state of Alabama, or shipped to the state of Alabama, for transplantation in our Center. The histocompatability laboratory is located on the 2nd floor of University Hospital and performs all histocompatability testing for patients undergoing kidney, pancreas, cardiac, bone marrow, lung, and liver transplantation. The patients undergoing transplantation are located on the 7th floor of the Spain-Wallace Tower with a separate hemodialysis unit for the management of these patients.
The clinical activities of this Division are multifold with primary emphasis upon patient care of those individuals with chronic renal and liver failure undergoing organ transplantation. The vascular access for hemodialysis in the Medical Center is also performed on this service. During 1993, 322 kidney transplant operations were performed and 280 were done in 1994. There were 675 vascular access procedures and 63 liver transplant procedures in 1994. Ongoing clinical research programs integrated with members of the faculty of the Division of Nephrology include the prevention of rejection of renal allografts by the use of new immunosuppressive agents. these clinical trials are approved by both the FDA and our own Institutional Review Board. Clinical research studies of tolerance have been completed using donor specific bone marrow infused as donor antigen. More recently, studies are underway with the clinical trials under NIH support. Physicians from the departments of Nephrology actively participate in the daily care of transplant patients with the surgical service and contribute greatly to the clinical research programs. A kidney/pancreas transplant program has been in effect since 1988. This program provides care for patients with Type I diabetes.
Liver transplants are performed in both adult and pediatric patients. The total number of liver transplant procedures performed at UAB since 1988 is 225. These patients are also located on the transplant floor of University Hospital.
The Division of Transplantation offers a 2-year fellowship for surgeons who have completed their General Surgery training and have an interest in academic renal transplantation. This program is approved by the American Society of Transplant Surgeons. The fellowship includes training in vascular access, renal transplantation, kidney/pancreas transplantation, and liver transplantation. There is an active research program pertaining to the immunologic aspects of graft rejection as well as its prevention using donor specific bone marrow.
Research studies involving the relationship of growth factors to surgical wound healing and, specifically, to their role in rejection, both acute and chronic are being performed. These studies have been carried out both experimentally and, more recently, involving clinical pathology specimens of kidneys. The transplantation is funded by NIH and other peer-reviewed grants.
The Transplantation Data Analysis Center provides a database on more than 3,500 patients who have undergone renal transplantation in this center since 1967 as well as recipients of liver allografts and kidney/pancreas allografts. This database forms the foundation for clinical research activities within the Division of Transplantation and the members of Transplant Nephrology in the Division of Nephrology. This computerized database is integrated with the Tissue Typing Laboratory which allows a day-to-day update of all patients who have undergone kidney, liver, and kidney/pancreas transplantation
The Transplantation Immunology Laboratory is funded by grants from the National Institutes of Health. The laboratory employs 2 full-time technicians and is completely equipped to perform a spectrum of in vitro humoral and cellular immunological assays for the cryopreservation of tissues. Currently, active research projects include investigation in the induction of allograft tolerance in both humans and animals utilizing anti-lymphocyte sera and donor bone marrow, and the transplantation of insulin-producing tissues into organoid implants. Planned future projects include a study of the influences of liver allotransplantation on the survival of small bowel allografts, and a study of approaches to desensitization of animals with the high titers of antibody to potential organ donor major histocompatability antigens. Transplantation Fellows are involved in the projects of the laboratory and provisions can be made to include residents who are interested in spending a flexible amount of time in the Transplantation Laboratory in order to gain experience in this area.
Inquiries regarding the Renal Transplantation Fellowship should be submitted to:
Devin E. Eckhoff, M.D.
Department of Surgery, LHR-710
Director, Division of Transplantation
University of Alabama at Birmingham
Birmingham, Alabama 35294-0007
Phone: (205) 934-7714