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Grenada, Biloxi transplant clinics enhance access to care

Published on Monday, December 7, 2015

By: Ruth Cummins .

Published in News Stories on December 07, 2015

Walking to school earlier this year with identical twin sister Ariana, Briana Blackmon of Holly Springs found herself lagging behind.

“She told me to speed up, and I couldn't,” said Briana, who was 17 and a Holly Springs High senior at the time. “I got to school and my side started hurting, and I threw up. My auntie took me to the hospital in Southaven.”

That's where her mom, Mabel Blackmon, ironically was at the bedside of the twins' dad. “She took me to the emergency room there, and they had to send me right away to Le Bonheur,” Briana remembered.

The children's hospital in Memphis quickly gave Briana and her north Mississippi family the news: Briana, who already was being treated for high blood pressure, was in acute kidney failure and needed to immediately begin dialysis several times weekly. They also learned Briana was a candidate for a kidney transplant.

“Some days, I would just sit and cry and not talk to anyone,” remembered Briana, who's now 18 and intent on graduating in May. “I was able to go to school, but I missed a lot.”

Briana and her family were referred to the University of Mississippi Medical Center's new transplant clinic on the campus of UMMC Grenada. She was among the patients seen April 24, the first day of clinic, by abdominal transplant surgeon Dr. Mark Earl and transplant nephrologist Dr. Kenneth Kokko. Grenada abdominal transplant coordinator Michelle Crawford had already begun the process of evaluating and testing her for transplant.

Briana quickly progressed to the transplant waiting list on May 12. She received her new kidney on June 5, making her the first patient evaluated through the Grenada transplant clinic to receive the life-changing surgery.

UMMC Grenada
UMMC Grenada

The clinic -- a satellite of the abdominal transplant program on the main Jackson campus - is providing much-needed access for Mississippians in the Delta and the northern half of the state who need care, but who might find it a hardship to travel to Jackson. So far, the Grenada staff has prepared about 125 patients for eventual surgery. Of that number, Crawford said, about 40 are on the transplant waiting list who meet certain criteria, including being on dialysis, and five have received transplants since April.

Patients come on the third Friday of the month, not just from the Grenada area, but from cities including Greenwood, Greenville, Tupelo, Tunica, Eupora, Sardis, Columbus and Indianola. A second UMMC satellite transplant clinic operates the first Friday of the month in Biloxi, further increasing access and drawing from the Mississippi Gulf Coast, the Mobile, Ala., area, and south Louisiana, Kokko said.

“The whole state is an underserved area for people with kidney failure,” said Kokko, the state's only transplant nephrologist.

Kokko and abdominal transplant surgeon Dr. James Wynn travel to Grenada from the Jackson campus and typically see 10-12 patients a month, all of them with end-stage renal failure and in need of either a kidney, or a kidney and a pancreas. “We can do all the diagnostic work in Grenada” that leads to patients being evaluated for placement on a waiting list, Kokko said.

The two also see patients at the Gulf Coast clinic that so far has evaluated about 50 patients in need of a kidney transplant, said Kara Smith, that clinic's abdominal transplant coordinator. A dozen of those patients are wait-listed for transplant at UMMC, with a number of others pending, Smith said.

“It's been wonderful to have such dedicated coordinators in Michelle and Kara. They're very efficient, and it allows us to increase access to transplant patients in the state,” Wynn said. “It's a long way to Jackson for a lot of people, and it's easier for us to see them there than for them to come to the main campus.”

Those under 18 receive extra consideration for a transplant, but adults can wait anywhere from four to seven years, Kokko said. According to the Mississippi Organ Recovery Agency, about 1,500 Mississippians are on an organ transplant list. Even so, the waiting period can be shorter than in neighboring states including Tennessee and Louisiana, Kokko said.

“We have an advantage in Mississippi in that we have a relatively good supply of organs and relatively few people on a transplant list,” Wynn said. “We need to extend the access to more patients. I'd love to see the Grenada clinic get to two days a month, and expand it so that we not only do pre-transplant evaluations, but also post-transplant follow-up.”

The transplant team at UMMC, as of early November, this year had transplanted 67 kidneys, five pancreases, 23 livers and 10 hearts in adults, and five kidneys and two hearts in children.

Christopher Anderson
Anderson

Dr. Christopher Anderson, chair of the Department of Surgery and chief of the Division of Transplant and Hepatobiliary Surgery, transplanted a donor kidney into Briana. He did the same for another teenager, the second kidney recipient who came through the Grenada clinic, just weeks later. “She has had wonderful doctors by her side, talking to her the whole time and letting her know what happens,” Mabel Blackmon said of Briana.

Merigold resident Gerri Weeks, 51, is among those whose hope for a new kidney began with an appointment at the Grenada transplant clinic. Diagnosed with diabetes and high blood pressure in her 20s, Weeks said her kidneys became increasingly stressed with age.

After a bad bout with pneumonia early this year, Weeks said, “it started to shut my kidneys down.” She began dialysis treatments in March at a center in Cleveland. “I cried every day. I didn't want to go,” she remembered. “But I kept coming, and I realized that cleaning my blood was keeping me alive.

 “The social worker here said she'd recommend me to the Grenada clinic. She got everything set up with an appointment, and we started from there in September.”

Her name was added to the transplant list Nov. 4. She continues dialysis, goes back to the Grenada clinic for lab work, and prays for the lifesaving surgery. “It's definitely more convenient to go to the Grenada clinic,” Weeks said. “It's only about an hour. My daughter is working, and she has to drive me there and get back to work.

Weeks
Weeks

“I thank God for a kidney if I can get one. I won't have to go to dialysis anymore, and I can be with my children and grandchildren.”

Crawford and transplant administrators say the Grenada clinic's success is an example of the partnership between UMMC Grenada and the Jackson campus. Grenada staff playing a key role include Helena Woods, manager of patient access; Julia Parker, laboratory secretary; David McGregory, laboratory director; Amy Palmer, radiology clerk; Mark Turner, nuclear medicine technician; Amy Green, ultrasound technician; Beverly Hill, echocardiogram technologist; and licensed practical nurse Lindsey Hill.

“This works as well as it does because of the continuous communication and coordination. Michelle gives us a list of the patients who will be coming in, and we all know what to expect,” McGregory said.

The Grenada team has worked to give patients a better experience by reducing as much as possible the amount of blood that must be drawn for pre-surgery and post-surgery testing. “We work with Michelle to coordinate lab work as she sees patients before their Friday appointment,” McGregory said. “Our goal is to have everything done so that when the doctor comes from Jackson to see the patient, he sees their labs. It's all done in advance.”

“Our goal is to get people back toward wellness, and to get them as close to normal as we can. Transplant is a great treatment that, from a quality of life standpoint, is wonderful for patients,” Wynn said.

Briana takes from her journey not just a chance at a normal life. She believes she's found her calling.

“I want to be a dialysis nurse, but I want to work with kids,” she said. “I think that I can understand what they're going through.”

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