Shimul A. Shah, MD, UC Health surgeon and the James and Catherine Orr Endowed Chair in Liver Transplantation, director of the Division of Transplantation and professor of surgery at the University of Cincinnati College of Medicine, saw a need and identified critical opportunities that would enable UC Health to continue to perform transplants.
“The most important part of our ability to do this was our strategic approach as a health system to the pandemic, as it related to organ donation and transplantation,” said Dr. Shah. “Once we saw that Ohio had lower COVID-19 rates than other states, we decided to move forward with a ‘one day at a time’ mindset. Our goal was to continue to perform transplants once we observed that it was safe and not harmful to patients.”
UC Health teams monitor equipment and supply resources daily (intensive care unit (ICU) beds, ventilators, personal protective equipment (PPE), operating rooms, staff and blood products) to ensure they are in place to perform transplants, but first used for COVID-19 patients.
“At UC Health, we have done a great job of working together as a system through all facets of our clinical, administrative and support teams,” Dr. Shah said. “Our transplant team, COVID-19 task force, emergency preparedness team, surgical team and many other teams—have effectively communicated and made smart decisions together.”
UC Health’s COVID-19 Task Force, on which Dr. Shah sits, along with UC Health’s leadership team, closely and cautiously monitor the progression of the virus within the state and in other states where organs were being harvested. When Ohio did not see the expected surge of COVID-19 cases that was originally predicted, UC Health made a conscious decision to move forward, adhering to the highest levels of patient and provider safety and care.
Immunosuppression protocols—the partial or complete suppression of a person’s immune response induced to help the survival of an organ after a transplant operation—were evaluated and modified as needed. “As a system, we honed our approach which included the proper balance of safety, detailed enhancement of transplant surgery protocols and an assertive attitude so we could continue to save lives,” Dr. Shah added.
During the organ harvesting process, the UC Health Transplant team closely tracked how much COVID-19 was in other hospitals that had potential organ donors. They also ensured that when they decided to work with a hospital, that any/all organ donors coming from those hospitals (located inside and outside of Ohio) were COVID-19 negative. “We are extremely careful, and in the beginning, we actually walked away from a couple of donor hospitals who had very high COVID-19 rates,” said Dr. Shah.
Sean Davis, 46, of Union, Ohio, had a liver transplant in the midst of the COVID-19 pandemic. Diagnosed with Primary Sclerosing Cholangitis (PSC), a chronic liver disease, he was placed on the liver transplant waitlist at UC Health in Oct. 2019. He recalls that he received a call from Dr. Shah at 6 a.m. on Easter Sunday, April 12, 2020. “He told me, ‘I have a good organ for you, and you need to come to UC Medical Center right away.’”
Sean remembers feeling nervous and a little afraid when he arrived at the hospital.
“My wife and kids dropped me off at the hospital. I’ll admit that it was scary walking in by myself without my family, but I was ready,” Sean said.
Sean did not see Dr. Shah before his surgery that day. Dr. Shah explained to him that in order to minimize any risk for COVID-19 for patients and providers, they wanted to have as little contact as possible.
Cutler Quillin, MD, UC Health surgeon and assistant professor of surgery at the UC College of Medicine, was assigned to see Sean in the hospital while he recovered after the surgery.
“Dr. Quillin took over while I was in the hospital for my post-surgical care because they wanted to minimize the number of people I was exposed to,” said Sean. “They were amazing. I can’t imagine what they have dealt with during this time.”
Sean observed as nurses and other patient care staff went about their usual business of providing care. “The only difference I could see was that everyone was wearing masks, face shields and gowns. COVID-19 was in the background, but everyone was practicing patient safety.”
Sean says that it was challenging not to have family with him at the hospital, but praised how compassionate UC Health was, giving him all of the support he needed.
One week after his successful liver transplant, Sean was discharged. He continues to recuperate at his mother’s house in order to minimize risk to himself, his wife, Summer and his two daughters, Sidney and Taylor, who remain at their home.
“We text, FaceTime and have outdoor, socially-distanced visits almost every day,” Sean said. “I just look forward to being able to hug my wife and kids.”
Sean continues to have regular virtual visits with Dr. Quillin and other care staff.
“They told me it’s like having a baby, when the nurse says it’s time to go home, and you think, you’re letting me take this baby home?” Sean said. “Organ transplantation feels very similar—the organ is yours now, and you have to take care of it.”
UC Health Transplant Team Places Patient Education as Top Priority
Dr. Shah has taken a proactive virtual approach with providing patient education to those who are on the transplant waitlist, patients who recently had transplants and those who are six-months post-surgery. He has held two WebEx sessions, on April 1 and April 29, to provide accurate COVID-19 information, clarify news reports and rumors, and provide tips for living in the current COVID-19 world. So far, more than 100 patients have participated. Dr. Shah plans to do more sessions in the future.
“Part of our role at UC Health is to educate our patients,” Dr. Shah said. “It’s important that patients receive information from someone they trust. And who do they trust more but their transplant team and their doctors?”