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University of Maryland Medical Center's longstanding national prominence in organ transplantation has been further elevated with its recent status as the leading center in the United States for performing kidney transplants in African-Americans.

Data from the United Network for Organ Sharing shows UMMC performed more kidney transplants in African-Americans in 2014 than any other center in the country — a total of 128, including both living and deceased donors. These patients represent just under half of the 270 total kidney transplants done at UMMC that year, according to Jonathan Bromberg, M.D., Ph.D., chief of the Division of Transplantation at UMMC and a professor of surgery, microbiology and immunology at University of Maryland School of Medicine.

Several compelling factors explain UMMC's excellence in this aspect of kidney transplantation, Dr. Bromberg says, including its commitments both to surgical innovation and to serving the needs of the patient population in the Baltimore-Washington area and beyond.

"It's part and parcel of who our patient population is here in the Mid-Atlantic region and particularly the Baltimore area, and it's important in terms of really serving your population," he explains. "We can find any number of research papers detailing the unfair distribution of healthcare among various populations in the country. This shows our outreach efforts to our community are very effective."

Aggressive Efforts to Increase Donor Pool

Although African-Americans comprise about 13% of the American population, they represent 34% of the patients waiting for a donor kidney in the United States, according to the U.S. Department of Health and Human Services. In 2014, 73% of African-American organ transplant recipients received kidneys. Because this population experiences higher rates of diabetes and high blood pressure than other racial groups, it is especially vulnerable to end-stage kidney disease, for which organ transplant is considered the gold standard long-term treatment.

But UMMC does more kidney transplants in African-Americans than even its peer institutions nearby, from Philadelphia to Washington, D.C., who serve the same patient population or similar numbers of African-Americans, Dr. Bromberg notes.

"We tend to be very aggressive in terms of accepting patients and accepting organs," says Dr. Bromberg, a kidney and pancreas transplant surgeon who came to UMMC in 2010 and is a renowned expert in transplant immunology. "That's been the history of this program."

UMMC's efforts to offer specialized kidney transplants have helped increase the donor pool to its patients. For example, UMMC is among a small handful of medical centers that transplant type A2 cadaver kidneys — a subtype of the highly common blood type A — into kidney failure patients with type B blood, which is particularly common in African-Americans. UMMC also boasts unusual abilities in offering multiple renal artery kidney transplants, a complex surgery — required when donors have multiple renal arteries instead of a single artery — which many other high-volume transplantation centers can't do.

Expertise Guides Use of Living Donors

UMMC's program is also aggressive in offering kidney transplants to obese patients, even those whose BMI (body mass index) exceeds 35 or 40. "When they have renal failure and are obese, they can't really exercise and have many restrictions," Dr. Bromberg explains. "For these people, losing weight is almost impossible."

But UMMC transplant clinicians also employ their expertise in discerning which family members of kidney transplant hopefuls can successfully provide a kidney to their loved one without putting their own health in jeopardy. Since conditions such as obesity, diabetes and high blood pressure can run in families, "our expertise comes in having very good, stringent screening so we're not accepting some younger donors and putting them at risk of developing renal disease later in life," Dr. Bromberg says.

Assessing potential live donors' BMIs, glucose levels and other factors help UMMC physicians make prudent decisions, ensuring good outcomes for both kidney donors and recipients.

"We also have a long discussion with family members about the risk," he says. "We don't want to put any potential donor at significantly increased risk of having a bad outcome 20, 30 or 40 years later … they might need that kidney."

For more information on the transplant program, please contact 410-328-5408.