My Incredible Experience with the first U.S. Face Transplant

ITNS
International Transplant Nurses Society Newsletter
In this issue
2
Book Review
Fall
‘09
Volume 18,
Issue 3
2
President’s Message
3
IQ Series
12
Portrait of an ITNS Chapter
My Incredible Experience with
the first U.S. Face Transplant
By Renne Bennett, Rn, BSN, CNOR, CCTN, CCTC Newsletter Editor, ITNS l Cleveland Clinic
This past May the world was introduced to an
Ohio mother of two who had become the first U.S.
face transplant recipient. At a press conference,
patient Connie Culp repeatedly thanked the medical
staff and the donor family for the successful December 2008 surgery that now allows her to more easily
“blend with society.” Standing with Connie at the
press conference that day were the members of her
medical team at Cleveland Clinic who had made it
all possible, including ITNS Newsletter Editor Renee
Bennett, RN, BSN, CNOR, CCTN, CCTC. Below are
some of Renee’s impressions.
When I was first asked by my administrator four
years ago to serve as a consultant to the Plastic Surgery group as they formulated their plans to perform
the world’s first face transplant, I easily said yes. I
naively thought it would be a couple one hour meetings and my involvement would be finished. Little
did I realize that I would be involved in a case that
made transplant history and also became one of the
highlights of my career. This case, in my opinion, was
the single best example of collaboration between
all three entities in transplant: the donor hospital,
the Organ Procurement Organization (OPO) and the
Transplant Center.
ITNS: When and how did you first find out that you
would be responsible for coordinating the transplant?
Renee: I was asked to be involved in an initial meeting about four years ago. I had helped with setting up
the team for the second laryngeal transplant (which
never actually happened) and because I have had
such an extensive history with the role of donor coordinator. After the initial meetings where I developed a
time-line and transplant surgery call protocols, I was
asked to participate in the IRB protocol. From there a
potential patient was identified so I was asked to participate in the evaluation process. Even though there
would not be an official UNOS listing, the team wanted
to follow our transplant center and UNOS guidelines
for approval and listing as closely as possible. Eventually, this patient was identified as our first candidate.
From there, I participated in the approval process of
our local OPO’s medical advisory board and their subsequent education process. For about eight months, I
was “on call” whether in town or out of town to assist
in setting the transplant if a donor was identified and
consent was obtained. So everywhere I went for those
months I carried my face transplant donor folder and
kept my cell phone with me.
ITNS: What, if anything, prepared you for the work
you had to do during this process?
Renee: I had taken donor call for many years and
worked with several different organs. I knew the OPO
team very well and it was felt that I could work closely
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with them in making this unusual consent and donation a reality.
ITNS: What were some specific obstacles/hurdles for
you professionally?
Renee: Hurdles included the very slow process of
IRB approval and OPO approval. Then next was finding the right donor, not just by inclusion/exclusion
criteria but that the family was so “pro donation” that
they would truly feel this is something their loved one
would have wanted. The only personal hurdle was
being on call constantly. It certainly wasn’t the volume of offers; it was the sense of responsibility.
ITNS: What did you learn that might shed any new
light on the transplant process or transplant nursing?
Renee: The biggest thing I learned was something
I knew all along. Miracles can happen when all the
teams come together for a common goal. The change
we made in this patient’s life (and she was a team
member as well), will alter her life and transplant forever. I was a very small part of an incredible team but
I am incredibly proud to say I was there. •
Upcoming ITNS
Board Meetings
September 23
Montreal Canada
November 13-14
Columbus, Ohio, USA
ITNS
2
President’s message
Setting and Reaching our
Transplant Nursing Goals
By Clare Whittaker RN, BSc (Hons) l The Royal London Hospital, London, UK
This
year as always, the Board of Directors are
committed to you, the membership and to promoting
the mission and goals of your organization, the International Transplant Nurses Society. It has certainly
been a busy year with some great achievements that
we can all be proud of...
During the year we saw the development and
publication of the IQ Series, which will be available
soon. The Series will continue to grow and we will
work on the translation of the DVDs to reach as many
of our members as possible. It is
hoped that the DVDs will replace
the need for the certification review
course and allow us the opportunity to deliver other educational
initiatives.
The work put into developing the Scope and Standards of
Transplant Nursing led to the recognition of Transplant Nursing as a
Specialty by the American Nurses
Association. The efforts, headed by
Dr. Cindy Russell and all the contributors must not be overlooked,
as this is a huge step for transplant
nursing and will lead to further
development of competencies.
ITNS has been very fortunate to receive a grant
to produce audio discs of all of our Patient Information Booklets, allowing us to reach even more of
our patients with valuable information in support of
the education you deliver to your patients each day.
Support for this patient initiative came from the J.
Samuel and Rose Y. Cox Foundation.
Our bylaws have been reviewed, changes
proposed and discussion will take place at the
Symposium in Montreal. Voting on acceptance takes
place in October. This is to ensure that we are operating according to Pennsylvania law where ITNS is
incorporated and to ensure that ITNS is able to keep
moving forward.
We have been able to exhibit in a number of
locations and have been working on collaborative initiatives with the European Society of Transplantation
and the International Transplant Paediatric Association (IPTA).
The Staff Nurse SIG will be hosting its first workshop at the Annual Symposium in Montreal and the
Pediatric SIG will hold its first meeting. In 2010 ITNS
will be hosting a pediatric workshop.
The web site has undergone a great facelift and
the new provider is allowing ITNS to move forward
with online shopping and booking for meetings as
well as membership renewal.
It has been an honor and a privilege to serve you
all as your elected President. I shall be handing the
gavel over to Beth Kallenborn at the Symposium and
I look forward to assisting Beth in my emeritus year.
I would like to thank all members of the Board and
the membership who have supported me during my
tenure. •
ITNS Book Review
By Barb Schroeder, MS, RN, CNS l Organ Transplant Clinical Nurse Specialist l Mayo Clinic Rochester, Minnesota
Title: Inspiring the Inspirational: Words of Hope from
Nurses to Nurses
Author: Sue Heacock, RN,
MBA, COHN-S
Publisher: AuthorHouse, 2008
Sue Heacock has a diverse background in nurs-
ing and in life. She was a Military Police Officer in
the U.S. Army and worked in human resources and
equal employment opportunity before becoming a
nurse. With over 12 years nursing experience, including working in research, pediatrics and occupational
health, Sue brings a varied wealth of knowledge to
you. She is a Certified Occupational Health Nurse
Specialist and recently earned an MBA. She has
lived in many places around the country and in Germany.
Her lifelong dream of publishing a book was
achieved in late 2008 with the release of Inspir-
ing the Inspirational: Words of Hope from Nurses
to Nurses, a compilation of inspirational stories for
nurses.
The author starts out her book with a variety of
inspirational quotes about nursing as an art.
“Nurses – one of the few blessings of being ill”. –
Sara Moss- Wolf
“Bound by paperwork, short on hands, sleep and
energy… nurses are rarely short on caring”. – Sharon
Hudacek “A Daybook for Nurses”
“Caring is the essence of nursing”. – Jean Watson
The book includes six chapters:
•Philosophies to Think About
•Kids and Nursing
•Nurses Inspiring Nurses
•Simply Funny
•Simply Inspirational
•Philosophies to Keep with YOU
In each of the chapters the author has multiple
nurses write stories about their interactions with
patients. Although the stories are of patients of varying ages and from places throughout the United
States, the themes are apparent in each of the short
stories. The book is about nurses and how they make
a difference both big and small in their daily practices.
Beware; the spirits of the patients in these stories may make you laugh, cry, or cheer out loud. They
may even take you on a journey of reflecting on the
patients who have left an impact on your life. The
book is a fast read and is only 145 pages long — but
not short on humor and the human spirit. •
3
ITNS
Submitting an Abstract:
What NOT to Do
Though it seems like a long way off, the
2010 ITNS Symposium is planned for Minneapolis,
Minnesota. Starting in December of this year, the
Planning Committee will encourage ITNS members
to submit abstracts for either a poster or oral
presentation.
Many of you have interesting, informative and
innovative ideas and projects to share with our membership. You can submit several types of abstracts
including a case study, a research project, a quality
improvement initiative, or an informational/educational lecture. Abstracts are submitted electronically
via a link on the ITNS website. However, you must be
careful to follow all of the submission guidelines so
that your abstract will be considered for selection.
Below is a list of the Top 10 reasons why abstracts
are NOT selected.
10. The abstract is not in the correct format (for
example, a research abstract does not contain all of
the required elements, such as purpose, methods,
findings, etc.).
9. The abstract is not submitted by the deadline.
3. A research abstract does not indicate that the
research project has received Institutional Review
Board (IRB) approval and meets Health Insurance
Portability and Accountability Act (HIPAA) requirements.
8. The abstract is incomplete.
2. A research abstract does not include research
7. The abstract is too long (that is, the text does not
fit within the text box).
findings.
6. The speaker biography information is missing or
incomplete.
So remember, the 2010 ITNS Symposium Planning Committee wants YOU to present your paper
or poster in Minneapolis! Look for more information
about the abstract submission process in future editions of the ITNS newsletter, email updates and on
the ITNS web site. •
5. The required educational objectives are not
included.
4. The abstract is not blinded (that is, the narrative
section in the text box contains information about the
submitter’s institution, city, state, etc.).
1. An abstract was never submitted!
Executive Director Update:
ITNS Transplant IQ Series
By Beth Kassalen, MBA, Executive Director ITNS
ITNS had perfect timing on this one! With the
downturn in the US and world economies, ITNS is just
in time to help our members who had their CE and
travel budgets cut this year. The ITNS Transplant IQ
Series is a DVD set comprised of 16 key transplant
topics. The entire set costs $350 for members and
$500 for non-ITNS members and individual topics
are $35 and $50 based on membership status as
well.
The ITNS Transplant IQ Series was specifically
designed to replace our live lectures from the Transplant Certification Review Course that occurred twice
annually. ITNS received so many requests to hold
this course in a particular city that we decided to
invest in a DVD series to educate many, many nurses,
especially those who do not have the travel funds to
attend an actual course.
Because ITNS promotes certification, both the
Certified Clinical Transplant Coordinator (CCTC) and
the Certified Clinical Transplant Nurse (CCTN) will find
this series very beneficial in studying and preparing
for these exams. The IQ Series serves as a visual
complement to the ITNS Core Curriculum book and
to Transplant Nursing Secrets, both of which are typically used as study guides for taking these two American Board of Transplant Certification (ABTC) examinations.
But there is more…The ITNS Transplant IQ Series
also offers continuing education credits (CEUs) and
CEPTCs which are used by both coordinators and
certified transplant nurses. There is a $10 per person
fee per disc topic that applies for anyone requesting
credits for watching the Series. An evaluation and
post-test are incorporated as part of each disc.
Our goal is to educate as many transplant nurses
and coordinators as possible so the ITNS Transplant
IQ Series may be used by transplant educators to
teach, train and review with the scores of nurses
within their units or institutions. It can also be used
as dinner workshop presentations for our many
chapters around the world. While the DVD set carries
the FBI copyright warning and the DVDs cannot be
copied, ITNS does wish to have as many nurses view
the topics as possible so viewing is not limited to the
purchaser. Many nursing units will be using the DVDs
in a meeting room setting, educating as many nurses
as possible, perhaps using a moderator to interpret
and answer questions from the audience. Should
those in the audience need CEs or CEPTCs, the moderator can print out evaluations and post-tests for
everyone in the audience. Those nurses can then
each mail their evaluations, post-tests and $10 per
disc to ITNS, and ITNS will send out certificates.
At the present time, two of the talks (Immunology
and Histocompatibility) are available with subtitles in
10 different languages. All other topics are English
only until further grant money becomes available.
ITNS would like to acknowledge Astellas Pharma US
for an educational grant in support of this project.
Order your copy today and increase your Transplant IQ at www.itns.org. Full sets will be available
in October. •
Patient Audio CDs now available!
ITNS is now offering seven patient education fact sheets on audio CD to help our members meet the needs of
blind or visually impaired patients. The CDs come as a set and are free of charge to patients. Transplant Centers
wishing to distribute multiple sets have permission to burn each CD at their own cost. The seven topics are: Post
Transplant Diabetes, Pregnancy After Transplant, GI Side Effects, Dental Care for Transplant Patients, Health Lifestyles, Sun Care for Transplant Patients, and Diet and Exercise. Since 2005, ITNS has distributed over 75,000
of these brochures worldwide. The audio CDs are available in English only. The print copies of the brochures are
available in many different languages including Spanish, Portuguese, German and French.
ITNS
4
R esearc h update
Italian Transplant Nursing
Conference
By Cynthia L. Russell, Phd, RN l Director of Research ITNS l University of Missouri
On
June 18 and 19, 2009 in Florence Italy, the
Italian Transplant Nursing conference “Current Practice Future Challenges” was held at the Convitto Della
Calza in Florence, Italy. The number of attendees far
exceeded expectations with 231 delegates attending
from seven countries. Dr. Franco Filipponi, Dr. Paolo
De Simone, and Dr. Sabina De Geest presided over
the day and a half conference. Dr. Filipponi is the
Transplant Director of Pisa Transplant Program, Dr.
De Simoni is Director of the Liver Transplant Program
in Pisa, and Dr. De Geest is Professor of Nursing and
Director of the Institute of Nursing Science of the
Faculty of Medicine at the University of Basel, Switzerland. The International Transplant Nurses Society
sponsored the conference.
Welcome messages were also provided by Dr.
Gensini, Dean of the Florence University Medical
School, Florence, Italy; D. Massai, Tuscany representative of the Italian Nurses Society in Florence,
and E. Rossi, Tuscany Health Minister, Florence. The
conference began with Dr. Fabienne Dobbels and Dr.
Paolo De Simone chairing the session “Transplant
Nurses: Role Definition and Scope of Practice”. Dr.
Cynthia Russell, ITNS Research Director, and chair of
the Transplant Nursing Scope and Standards of Practice development task force, presented “Transplant
Nurses: Role Definition and Scope of Practice in the
United States”. Sarah Tizzard, Clinical Nurse Specialist for Viral Hepatitis at King’s Hospital, presented
the prospective from the United Kingdom. A lively
discussion followed between the audience, speakers
and the discussants, Flora Coscetti, Transplant Nurse
Coordinator from Pisa, Dr. Sabina De Geest, and
Gerda Drent, from Groningen, The Netherlands.
After a coffee break on the courtyard of the very
beautiful Convitto Della Calza, Drs. Christiane Kugler
and Cynthia Russell, chaired the session, “Building A
Common Platform for Transplant Nurses in Europe”.
Lucia Rizzato from the Italian National Center for
Transplantation in Italy presented “The Added Value
of Nurses in an Integrated Model of Transplant Care:
The Italian Normative Frame”. Then Dr. De Simone
presented “Sharing and Improving Standards of
Practice for Transplant Nursing”. Dr. De Simone challenged nurses to continue to develop professional
practice in transplantation. Discussants for this session were Flora Coscetti, Dr. Sabina De Geest, and
Gerda Drent.
A delicious lunch of Tuscan food was enjoyed,
again served in the sunny, geranium-encircled courtyard. The afternoon session began with the second
session “Advanced Nursing Practice in Transplantation” chaired by Dr. Thierry Troosters, and Dr. Paolo
De Simone. Dr. Petra Schaefer-Keller, from Basel
Switzerland, presented “Current challenges of
advanced practice in solid organ transplantation”.
Gerda Drent presented “Advanced Nursing Practice
in Liver Transplantation”.
Participants in the Italian
Transplant Nursing Conference
from left to right: Dr. Sabina De
Geest, Dr. Fabienne Dobbels,
Gerda Drent, Dr. Paolo DeSimone,
Dr. Christiane Kugler, ITNS,
International Director, Dr. Cindy
Russell, ITNS Research Director,
Dr. Thierry Troosters.
Alessandro Nanni Costa from the Italian National
Center for Transplantation discussed “The Role of
Transplant Nurses in Light of the European Union
Draft Directive on Organ Transplantation.”
The final Session of the afternoon was “Organizational Issues in Transplant Nursing”, chaired by
Gerda Drent and Juri Ducci, Transplant Coordinator,
Pisa. Dr. Fabienne Dobbels presented “Principles
of Chronic Illness Management in Transplantation”,
Dr. Thierry Troosters, “Multidisciplinary Transplant
Rehabilitation”, and Dr. Christiane Kugler, “Factors
Contributing to Favorable Working Conditions for
Transplant Nursing”.
That evening a glorious gala dinner was served
under the lights of the Convitto Della Calza’s
veranda. The meal of various fish specialties from the
Tuscan region was carefully selected for the evening
and the warm weather.
The second day included a morning workshop
“Questions at the Cutting Edge of Patient Adherence
in the Transplant Population”. Dr. De Simone and
Gerda Drent chaired the session with the following
presentations, “Patient Adherence in Transplantation:
Where we are, Where we are going” by Dr. De Geest;
“Pretransplant Patient Adherence and its Impact on
Transplant Outcome” by Dr. Fabienne Dobbels; “Monitoring of Post-Transplant Patient Adherence” by Lut
Berben, Research Assistant, from Katholic University
in Leuven; “Adherence in Liver Transplantation: The
EAST Study” by Juri Ducci; and “Computer-assisted
Learning in Transplantation” by Dr. Schaefer-Keller.
The final workshop was “Transplant Nursing Education”, chaired by Dr. De Geest and Flora Coscetti. Dr.
Russell presented “The ITNS Curriculum”, Lidiana
Baldoni, Head Nurse of the Department of Liver
Transplantation, Hepatology, and Infective Diseases
of the University of Pisa Medical Hospital and Senior
Transplant Nurse Coordinator, Pisa, discussed “The
Pisa Curriculum”, and Sarah Tizzard talked about “In
Search for a European Core Curriculum in Transplant
Nursing”. The discussion focused on what next steps
could be taken to begin to move toward transplant
nursing standardization across Europe. Dr. Russell
suggested that the next steps could involve examining core competencies for transplant clinical nurses,
transplant nurse coordinators, and transplant
advanced practice nurses across the world to find
commonalities.
The ITNS booth was visited by many with several new ITNS members recruited. Klara Redmond,
Assistant to Dr. De Geest and Hannah Buckhalter,
Master’s Student, Katholic University very graciously
agreed to assist with the ITNS booth. The conference
was a great success! Thank you Dr. Flipponi, Dr. De
Simone, and Dr. De Geest for involving ITNS in this
fabulous tribute to transplant nursing in Italy and
beyond! •
5
ITNS
wellspirit
Acupuncture: What you need
to know.
By Barb Schroeder, MS, RN, CNS l Organ Transplant Clinical Nurse Specialist l Mayo Clinic l Rochester, Minnesota
Complementary therapies (although
this term was not originally used) and their basic
philosophies have been a part of nursing since its
beginning. In Notes on Nursing (1859/1936) Florence Nightingale stressed the importance of creating
an environment in which healing could occur and the
importance of therapies such as music in the healing
process.
Research has shown that acupuncture reduces
nausea and vomiting after surgery and chemotherapy. It can also relieve pain. Researchers don’t fully
understand how acupuncture works. It might aid the
activity of your body’s pain-killing chemicals. It also
might affect how you release chemicals that regulate
blood pressure and flow.
“These chemicals will either
change the experience of
pain or trigger the release
of other chemicals and neurotransmitters that influence
the body’s own internal
regulatory system.”
Complementary therapies are receiving increasing attention within nursing. Because of their increasing use by patients and because patients expect
health professionals to possess knowledge about
complementary therapies, it is critical that nurses
have this knowledge in order to assist their patients
and family members. This article will focus on the
use of acupuncture.
What is Acupuncture?
Acupuncture is the practice of inserting very thin,
sterile, disposable needles into specific body points
at certain depths to improve health and well-being.
It originated in China more than 2,000 years
ago. It is based on a belief in Traditional Chinese
Medicine that imbalances or blockage in the basic
flow of energy through the body Qi (pronounced chee)
causes illness. Qi is believed to flow through channels in the body known as meridians. The meridians
are accessible through different acupuncture points.
From a western scientific point of view, acupuncture stimulates the nervous system to release chemicals in the muscles, spinal cord and brain. These
chemicals will either change the experience of pain
or trigger the release of other chemicals and neurotransmitters that influence the body’s own internal
regulatory system. This is called the “acupunctureendorphin-hypothesis”.
By inserting fine needles into the acupuncture
points in various combinations, practitioners believe
that the body’s energy will rebalance and natural
healing mechanisms will occur. Treatment may take
place over a period of several weeks or more.
Preliminary studies show that acupuncture may
relieve symptoms for disease and conditions ranging
from back and neck pain, to pain during and after
surgery to depression.
Acupuncture, in conjunction with conventional
treatments may help conditions or diseases such
as: addiction, stroke rehabilitation, headaches, menstrual cramps, tennis elbow, fibromyalgia, osteoarthritis, low back pain, carpel tunnel syndrome and
asthma. This combination may be an acceptable
alternative to conventional treatments alone and may
be part of a comprehensive management program.
Further research is likely to uncover additional areas
where acupuncture is useful.
Key Points
1. Acupuncture is safe when performed properly.
2. It has few side effects.
3. It can be useful as a complement to conventional
therapies.
4. It is becoming more available in conventional
medical settings.
Risks
The most common side effect of acupuncture is soreness or minimal bleeding and/or light bruising at
some needle sites.
Acupuncture may not be safe if you have a
bleeding disorder or if you’re taking blood thinners.
Patients would need to discuss this with their physician and acupuncturist.
Choosing an Acupuncturist
Do the same thing you would do when choosing other
health care providers. Ask your physician for a recommendation or ask people you trust. Many patients will
have an intake interview with the acupuncturist to
determine how likely it is to help. Ask how much it will
cost and whether it would be covered by insurance.
Let your physician know you are considering acupuncture and they may be able to tell you how successful it is in treating your condition.
For more information visit the National Center
for Complementary and Alternative Medicine at www.
nccam.nih.gov/
A special thank you to Marina Keppler, LAc, MA,
Dipl.Ac Naturopath, for her suggestions and review of
this article. Marina is the owner and acupuncturist at
Riverseasons, LLC, in Rochester, Minnesota,
USA. •
ITNS
6
How Our Membership Celebrated
Transplant Nurses Day 2009
For the fourth year in a row,
ITNS members far and wide
celebrated Transplant Nurses
Day in their own way. Read
these descriptions below to
get some great ideas for your
own celebration next year!
Baylor University Medical Center, 14R Transplant
Unit celebrated Transplant Nurses Day by providing
a luncheon for all staff members. Staff also participated in Transplant Trivia answering questions
about transplantation facts in the U.S. along with
trivia questions about Baylor Regional Transplant
Institute’s Program which celebrated its 25th Anniversary this year. Prizes awarded for correct answers
were the free gifts generously provided by ITNS. Our
Transplant Nurse of the Year was also announced in
recognition of her excellence in transplant nursing.
Submitted by Heidi Herbert, RN BSN CMSRN CCTN
14R Educator
The Hospital of the University of Pennsylvania,
Rhoads 4. On April 15, 2009 the Abdominal Organ
Transplant nurses at The Hospital of the University of
Pennsylvania (Philadelphia, PA) celebrated their specialty with a potluck style luncheon. Gifts were raffled
off to members of the nursing team to thank them
for the hard work and dedication they demonstrate
to our unit and our patients on a daily basis. Several
nurses were recognized for achieving their CCTN
certification this past year. A total of seven nurses on
Rhoads 4 at The Hospital of the University of Pennsylvania are now Certified Clinical Transplant Nurses!
The multidisciplinary transplant team which includes
our Certified Transplant Coordinators, Surgeons,
Social Workers, Nurse Practitioners, and Physicians
Assistants celebrated with the nurses and commended them for all of their achievements throughout the past year. Submitted by Rebecca Farrell RN,
BSN, CCTN Clinical Nurse IV
Beth Israel Deaconess Medical Center. In honor
of International Transplant Nurse Day, myself and
Norma Wells, Transplant Nurse Manager, hosted
a number of staff educational opportunities and
appreciation festivities including a game of Transplant Jeopardy, an educational and fun team-building
event! We love the work we do. We take pride and
care in our patient population and we look forward to
celebrating International Transplant Nurse Day again
next year! Submitted by Erica Gemellaro, Transplant
Unit Based Educator at Beth Israel Deaconess Medical Center of Boston, MA.
St. Louis University. The Abdominal Transplant
Office at St. Louis University celebrated Transplant
Nurses Day by treating all shifts of the floor and ICU
nurses to breakfast treats, served on the ITNS plates
and napkins. Names were drawn from a hat for the
giveaways. As an office, all members of the team
enjoyed a scrumptious pot luck brunch. Many of the
staff joined the other members of the Gateway Chapter in the evening for dinner, drinks and camaraderie
at a local Italian restaurant. Submitted by Kathy Howard.
St. Joseph Hospital, Orange, California. Our Donate
Life Celebration and festival coincided with Transplant Nurses Day. We set up booths in one of our
courtyards to bring awareness to employees and
patients about the value of donation. We had health
screenings and laptop computers people could log
onto and sign up to donate. We had food and entertainment as well. We raised the Donate Life flag and
the mayor was present to officially present a proclamation making April the official month in Orange,
California, recognizing organ, tissue, and bone marrow donation. In the morning we hosted a continental
breakfast for our transplant nurses and gave them
each a small gift. It was a fabulous day! Submitted
by Wendy Escobedo, RN, BSN, CCTN Inpatient Care
Coordinator St. Joseph Hospital Kidney Transplant
Orange, California. •
Julie Moore and Grace Foster at
the University of Illinois Medical
Center Organ Transplant Unit
picking names from a raffle on
Transplant Nurses Day. Inset is
Grace Foster with the lovely
Transplant Nurses Day cake for
the celebration.
7
ITNS
APT Pharmaceuticals Introduces New Lung Transplant
Ambassador Program
By Ana Stenzel with Sam Jones
As transplant recipients, we have walked a path
with our illnesses behind us, and the hope of a long
life due to transplant in front of us. This path has
been paved by those transplanted ahead of us and
all the knowledge gained from their successes and
failures. Today, we have the ability to walk side by
side making the path longer, wider and more scenic,
by participating in clinical research. Only through
patient participation in research studies, can progress be made to improve the success of transplantation.
I would like to introduce to you a new Lung Transplant Research Ambassador Program. The mission
of this critical program is to increase awareness,
support and involvement in lung transplant research
through outreach and patient advocacy. Through our
dedicated lung transplant recipient volunteers from
all over North America, we hope to collaborate with
distinguished lung transplant centers to educate
patients about the availability of clinical trials in lung
transplant medicine. By making patients aware of
the clinical trials available at their center, we hope
to increase patient participation and therefore further medical advancements in the field. Examples
of current ongoing research studies at our local lung
transplant centers include studies on the genetics of
graft dysfunction, inhaled cyclosporine, a new anti-T
lymphocyte immune globulin, and CMV infections. Sam’s story
I received my gift of a bi-laterial lung transplant in December 1999. At the time I was thinking
and praying -- “let me be better for a day.” With that
prayer answered I started looking for ways to help
others. One week after my transplant I hitched up
my IV pole with supplemental oxygen and drain tube
“buckets” to be able to walk to the next lung recipient’s room, and encourage her to succeed. I have
continued to help encourage others ever since. During the past years I have met nearly 500 lung trans-
plant patients -- always learning and always trying to
help.
My recovery was not smooth or uneventful, but I
was able to learn and explain what these issues
meant to new recipients with similar problems. While
in the hospital I had a pneumothorax in each lung,
developed CMV pneumonia and an asperguillous
infection, suffered dynamic airway collapse on my
right side, and the more usual heart irregularities
and blood pressure issues. I was sent home with
a PICC line, and would eventually do six IVs a day.
Through the years I have had three bouts of acute
rejection, four cardio-versions due to arrhythmia,
and a few hospitalizations for infections (fungal &
viral) and medicine adjustments.
“I owe my life to those who joined
clinical trials in the past and all those
who put their lives on the line in the
early days of lung transplantation.”
I am an advocate for lung transplant research.
Those who came before us led the way to perfect
surgical techniques, aftercare, medicines, and protocols to help us reclaim our lives. However, with 50%
of lung transplant recipients surviving only five years
we must actively support researchers, whose goals
are to increase our longevity. Only through verified
research can we move to more standardized types of
care, instead of one center doing what it feels is best
and another heading in an opposite direction.
Ana’s story
As a person who has lived with cystic fibrosis and
has had two lung transplants, I have experienced
the roller coaster ride of the lung transplant journey.
I experienced firsthand how chronic rejection of the
lung, which manifests itself as bronchiolitis obliterans syndrome (BOS), a mysterious and relentless
complication is unresponsive to a limited number of
risky treatments. BOS creates significant barriers to
quality of life and longevity in lung transplant recipients, compared to other solid organ transplants.
Currently the life expectancy of lung transplant
recipients is 50% survival in five years, much
shorter than other solid organ transplants.
This number has not changed since I was
first transplanted in 2000, while the long
term survival for kidney, heart and liver
recipients has. Such is the critical need
for lung transplant research to understand BOS and other complications.
As part of the new Lung Transplant
Research Ambassador Program,
fourteen volunteer Ambassadors
from around the USA and Canada
attended a training in San Francisco
in April 2009 to launch this program.
We brainstormed ways in which
we can increase awareness about
research opportunities in lung
transplant medicine through speaking at support
groups, mentoring patients who are recently transplanted, and spreading the word online. We welcome
others who may be interested in volunteering in this
effort. If you are interested, please see: http://lungtransplantresearch.ning.com/profile/AnaStenzel
The Lung Transplant Research Ambassador Program is sponsored by APT Pharmaceuticals, makers
of inhaled cyclosporine, which is the only phase III
clinical trial currently going on exclusively for lung
transplant recipients. This trial is open to adult lung
transplantation recipients who have been transplanted in the last 60 days. For more information
about inhaled cyclosporine, please see: www.cycliststudy.com.
Clinical trials are not exclusive to those with lung
transplants. I encourage anyone with a transplant to
inquire about research opportunities for their organ.
If you are like me and often feel frustrated that there
are more unanswered questions in the your transplant clinic than there are answered ones, I believe
one way to help find those answers is to get involved
in clinical studies. Talk to your coordinator or doctor
about what studies are going on at your center and
how you can get involved. Learn about the studies,
and the risks and benefits; decide for yourself with
your doctor’s guidance if participating in a clinical
trial or study could help you or others. Some people
are worried about being a “guinea pig.” Well, to be
honest, as transplant recipients, we are already
guinea pigs! Although it is considered the best option
for those with end-stage organ disfunction, no two
transplants are alike because no two donors and
no two recipients are alike. For more information on
transplant research opportunities available at your
transplant center, see: www.clinicaltrials.gov .
I know for a fact that without medical research
and the sacrifices of people with CF or organ transplants who came before me, I would not be alive.
Medical progress is a continuum, wove intricately
through the efforts of lab researchers, pharmaceutical companies, clinicians and patients; I am the beneficiary. I owe my life to those who joined clinical trials in the past and all those who put their lives on the
line in the early days of lung transplantation. I feel
strongly about the importance of medical research
and participation in clinical trials. When I was born,
my parents were told that I would live about 10 years.
Today, I am 37 years old. This is all due to medical
research. I have participated in several clinical trials
and observed the long challenging road of getting
new medications from the lab bench to the patient’s
medicine cabinet. It is the efforts of many. We can do
our part by participating in clinical trials and research
studies.
The Donate Life motto in California is “You have
the power to donate life.” Now, I stand before you as
beneficiaries of this motto, and would like to state:
“We have the power to prolong life” with transplantation by getting involved in research studies and giving
back. •
ITNS
8
C linical R eview C olumn
What can Clinical Transplant
Nurses Expect from Organs
Transplanted after Cardiac
Death (DCD) Donors?
By Frank Van Gelder, RN, BSN, ECTC l Scientific Consultant for the International Transplant Nurses Society l Mediconed Consultancy, Herent, Belgium
Introduction
Organ shortage remains the major limiting factor
to clinical application of multi-organ transplant programs worldwide. The effect on waiting mortality is
dramatic, and remains one of the most challenging
issues in organ transplantation. Those who take care
of patients pre-transplant know the dramatic and
often emotional impact for the patient and the relatives. Staying positive and hopeful while realizing that
clinical transplantation is no longer applicable to your
patient presents an emotional challenge for every
transplant nurse. Different initiatives have been taken and policies have been put in place to ensure the maximum
availability of organs from deceased donors. Besides
more awareness campaigns, legislative changes or
initiatives, the use of more so called “extended criteria donors” has shown to impact the number of available organs worldwide. Within this last group, the use
of organs of DCD donors is really something which
offers opportunities for the next decades. The safety
window, in which these organs can be used to ensure
equal clinical results, is something clinicians have
been working on for the past 15 years.
Death after cardiac death donors (DCD), have
been used since organ transplantation of deceased
donors was only starting up in the early Sixties.
In fact, the first heart transplant performed by Dr.
Christian Barnard in South Africa in 1968, originated
from a DCD donor. It was only until clear brain death
criteria were established that DCD donation was
performed. At that time, every clinical issue in transplantation was still new and the brain dead donor
with sustained oxygenated normothermic circulation
until proper removal of the organ seemed to be the
best possible and safest solution to start performing organ transplantation on a daily clinical base.
Beginning in the Nineties, with further development
of intensive care practices and better clinical results
of organ transplantation, clinicians started to use
organs from DCD donors more frequently.
Definition, Categories and Frequencies
When comparing both types of deceased donors,
brain death donors are donors in which the circulation to the brain and brain stem has irreversibly been
stopped. The cause of circulation stop lies inside the
brain (for example: trauma, hypoxemia, intracranial
bleeding). DCD donors are donors in which the cir-
culation to the brain and brain stem is irreversibly
stopped because of failure of the pump function of
the heart, which provides necessary oxygen to the
brain. When the temporary ceased circulation is
not restored, the brain will die within a few minutes
after the heart stops functioning. This definition
leads us to the proper categorization of DCD donors.
Dr. Kootstra, who was a pioneer in the Nineties to
present promising results with DCD donors, defined
four proper categories of DCD donors divided in
two groups, being uncontrolled and controlled DCD
donors:
1. Death on arrival (these donors show all signs of
death when a medical team arrives to the scene
in an uncontrolled setting). These donors are currently unlikely to be used as organ donors due to the
unknown warm ischemia period in an uncontrollable
setting;
2. Death after unsuccessful resuscitation (these
donors are declared dead after extensive resuscitation attempts in an uncontrolled setting). These
donors were extensively reported by the Kootsra
group in the Nineties, and are still used in a few European countries. The quality of the organs is sometimes superior, due to the young age and the shorter
impact of warm ischemia on the organ function.
These donors are often young trauma donors;
3. Death after withdraw life sustaining support (these
donors are in a clinical irreversible situation where
further treatment is futile in a controlled setting).
These donors are the most frequently used and
accepted in most of the clinical transplant programs
worldwide. The patients died after a certain period on
ICU where no progress and even deterioration of the
brain function has been reported, without yet reaching the classical brain death criteria;
4. Brain death donors with circulatory collapse (these
donors are declared dead on brain death criteria but
during the period after death declaration show an
irreversible circulatory collapse in a controlled situation). These donors are not so frequent and even
become rare due to well-established door maintenance and resuscitation protocols in ICU’s.
Within every category, proper monitoring of vital
parameters is an essential aspect in the clinical
application of these types of donors. Most of the
programs worldwide are currently using organs procured from categories 2, 3 and 4. Multiple ethical
debates and discussions took place prior to the use
of these donors. Especially the necessary time frame
between withdraw support or stopping resuscitation
and the start of the organ procurement needs to be
clearly stated in protocols. Additionally, a wide variety
of medication protocols have been developed for
improved organ viability, with specific attention to the
timing and ability to circulate these drugs. Cessastion
of circulation has been widely accepted as criteria
for clinical death, what is still unclear is the amount
of “stand off time” the transplant team must wait
after last heart beat but before procurement may
begin and which medications are allowable prior to
completion of the “stand off” period. More and more
programs have now started to develop the clinical
application of category 1 donors, after recent successful reports of the Madrid lung, liver and kidney
transplant groups.
The volume of organs these types of donors
could generate is potentially two times higher than
the current organs coming from brain death donors.
This immediately stresses the potential impact in
the supply of available organs to a proper society. On
a total population that dies on a yearly basis, only
between 0.04% and 0.07% are potential brain death
donors. The frequency of DCD donors compared to
this is at least double, turning between 0.5 and 1%.
Within the group of DCD donors, the highest potential
frequency lies within the group of category 3, death
after withdraw of life sustaining support.
Clinical Impact of DCD on the Function of the
Organ
Already many papers showed in the early Nineties,
the possible benefit of using organs of DCD donors
with comparable short and long- term results. One
very important element in comparing such results is
the etiology and clinical history of every donor used.
The evolution of the type of donors over the last two
decades has changed dramatically from using only
post-trauma brain death donors under the age of
50 towards donors of 80 or even 90 years old with
multiple morbidity risks such as diabetes and cancer. The dual factors of having not enough organs available and extended age of patients on the waiting
list, changed these policies significantly. The clinical
application of DCD donors came when the clinical criteria in brain death donors had dramatically changed
and had become very liberal. The combination of the
9
two groups now forces the different clinical transplant teams today to approach the type of donors
differently.
In a given example this would mean that a brain
death donor of 75 years old with diabetes type II can
be used perfectly as a liver donor, but that a DCD
donor of this age is a very high risk donor. The reason
is that the additional impact of temporary warm ischemia of a DCD donor added on to the clinical profile
of the 75-year-old donor with extensive co-morbidity,
can lead to primary non-function of the organ.
Based on international experiences, kidneys,
lungs and livers of DCD donors are reported to show
promising results after transplantation. Although the
liver shows a higher incidence of biliary complications post transplantation and a higher re-transplantation rate, still most of the programs show comparable results of these transplants compared with liver
transplantations coming from brain death donors.
Additionally, medical devices have been developed
over the past 20 years to sustain perfusion within the
organ when removed from the donor. Recent studies
have shown superior results in kidney transplantation, and promising data are shown in liver, heart and
even lung transplantation.
Many research programs invest in the analysis of
mechanism that occur in warm ischemia and develop
clinical protocols to avoid negative impact on organ
functions. Machine perfusion has two proper benefits. First, it sustains circulation in the procured organ
and opens the opportunity for conditioning the organ
in a better clinical status and it also informs the clinical teams with additional information on the proper
function of the organ creating a larger safety window
in the use of such organs for clinical transplantation.
The use of hearts from DCD donors have been gaining interest since medical devices are applicable.
Balancing well the clinical history of the donor in
combination with the effect of death on the organ is
a crucial combination every clinical transplant team
makes when evaluating an organ offer. Additionally,
the clinical status of the patient matched for the
organ completes the acceptance policy of every clinician handling organ offers and transplant patients.
Such decisions are often difficult, especially when
life saving transplants need to be done. In the use of
extended criteria donors and in this case especially
DCD donors, questions arise whether informed consent is necessary to use such organs. Ethically and
medically, most of the transplant programs use a
policy where every transplant candidate is informed
of the type of donor organs that can be offered once
listed. Mostly, the clinical transplant nurse taking
care of the patient pre-transplant informs the patient
and their relatives about the different types of organ
donors used. Such interviews should rather comfort
the patient than suggesting clinical teams transplant
low quality organs. For clinical transplant nurses on a
ward, preparing a patient for a transplant and/or taking care of a patient after transplant, these are elements one needs to keep in mind whenever an organ
transplant is declined or performed.
Even temporary delayed graft function is often
associated with DCD donors. But on a one -year post
transplant survival, the results are equal in both
groups. Recent studies suggest even a superior quality in DCD donors, because of less negative physiological impact compared to brain death donors. Many
data confirm dramatic impact on organ function dur
ing the so- called agonal phase, the moment brain
herniation takes place causing cathecholamine
and cytokine releases in brain death donors. When
certain symptoms occur post transplant in relation to
organ function, both donor and recipient factors can
influence the initial function of the organ.
Conclusion
DCD donors are again used for clinical transplantation. The combination of chronic organ shortage and
the increased interest and know-how, have opened
new opportunities in the wide clinical application
of organs procured from DCD donors. As clinical
nurses, today we are more involved in preparation
and guidance of patients on a waiting list or post
transplant. Although donor care is related to the
core tasks of procurement coordinators, the clinical impact of organ donor quality is something we
as clinical nurses in transplantation need to know.
The continuous efforts to control the increasing
organ demand, has led to the use of more extended
donors and different types of organ donors. Today,
the technology evolution opens new possibilities to
ITNS
ensure similar quality and long- term results in clinical transplantation. Properly installed guidelines and
clinical studies must guide every team using organs
from DCD donors. At least the medical society has
never stopped the effort and intention to provide our
patients with a new chance on life through an organ
transplant. Further development and larger clinical
studies will create the opportunity to install international protocols and guidelines when using organs
from DCD donors. In the constant search to tackle
the problem of organ shortage, strict clinical and
ethical guidelines go along with the drive to succeed
in offering an organ transplantation to every recipient on the waiting list.
References
Pomfret EA, SUNG RS et al. Solving the organ shortage crisis: the 7th Annual American Society of Transplant Surgeons’s State-of the Art Winter Symposium.
Am J Transplant 2008 Apr; 8(4)
Mason DP, Murthy SC, Gonzalez-Stawinski GV, Budev
MM, Mehta AC, McNeill AM, Pettersson GB. Early
experience with lung transplantation using donors
after cardiac death.
J Heart Lung Transplant. 2008 May;27(5):561-3.
Shemie SD. Clarifying the paradigm for the ethics of
donation and transplantation: was ‘dead’ really so
clear before organ donation? Philos Ethics Humanit
Med. 2007 Aug 24;2:18
Shemie SD, Baker AJ, Knoll G, Wall W, Rocker G,
Howes D, Davidson J, Pagliarello J,
Chambers-Evans J, Cockfield S, Farrell C, Glannon W,
Gourlay W, Grant D, Langevin S,
Wheelock B, Young K, Dossetor J. National recommendations for donation after cardiocirculatory death
in Canada: Donation after cardiocirculatory death in
Canada. CMAJ. 2006 Oct 10;175(8): S1.
Schold JD, Meier-Kriesche HU. Which renal transplant candidates should accept marginal kidneys in
exchange for a shorter waiting time on dialysis? Clin
J Am Soc Nephrol. 2006 May;1(3):532-8. Epub 2006
Feb 8 •
Web Site Update
ITNS Exhibiting
at Transplant
Social Workers
Conference
ITNS
Board Members Renee Bennett
RN, BSN, CNOR, CCTN, CCTC and Chris
Shay-Downer RN, BSN, CCTC will represent
ITNS at the Society for Transplant Social
Workers 24th Annual Conference October
13-16, 2009 in Cleveland, Ohio. The Conference takes place at the Renaissance
Hotel in Cleveland. Cost is $350 for STSW
members and $450 for nonmembers. For
more information, visit their web site at
www.transplantsocialworker.org.
In order to better meet the needs of the ITNS membership, the ITNS web page is currently
under reconstruction. The main goal of the redesign is to provide resources that promote
the education and clinical practices of excellence for transplant nurses. We are working on
components to make the site more current and user friendly. We anticipate that construction will be ongoing and we welcome your suggestions.
ITNS
10
c h apter update
What is an ITNS National Representative?
Representation by region for ITNS members works well in the USA and
Canada, and therefore Chapter development and membership is encouraged. However, ITNS is aware chartering a chapter in other countries may
prove difficult. In countries outside of North America, ITNS is seeking active
members who are interested in serving as a National Representative (NR)
for their country.
What are the criteria to become a NR?
•Active ITNS membership for at least one year
•Understand and agree with the vision and mission of the Society
•Membership in local transplant nursing and/or physician
organizations is encouraged
What are the responsibilities of the NR?
•Increase ITNS recognition and membership in your country
•Serve as a liaison between transplant nurses in your country and ITNS
•Collaborate with ITNS to identify and develop educational
opportunities in your institution/country
•Network between transplant nurses in your country
•Attend chapter-leaders meetings during the Annual ITNS Symposia
•Complete and submit the biannual report (as required by chapter
leaders)
•Serve for at least two years as a NR
How to become a NR?
•Fill in the application form
•Submit a recent CV/resume
•Fax your application form and CV/resume to ITNS head office at
+1-412-343-3959 or email to [email protected]
The ITNS Board of Directors (BOD) will review your application. If your application is approved by the BOD, the Chapter Development Director of ITNS
will send you a confirmation letter. Your correspondence address will be
added to the chapter leaders list on the ITNS website.
If becoming a National Representative is interesting to you, more information is available by contacting the ITNS office via the information above
or on the ITNS website (www.itns.org) under ITNS Chapters.
11
Self-Assessment Examinations Available at the ABTC
Web Site
ABTC has a self-assessment examination (SAE) that can help candidates prepare for the CCTN examina-
tion. The SAE is 75 questions long – 50% of the total number of questions on the actual certification examination — and follows the same examination specifications as the real examination. The SAE was developed to
be parallel to the certification examination and includes the same distribution of questions per major content
area, the same distribution of questions at each cognitive level (recall, application or analysis) to provide you
with a realistic examination experience. The SAE was designed to be an assessment tool to provide you with
areas of strengths and weaknesses and not a study guide.
Individuals who purchase the SAE will receive a link to the web-based product in their email. Once you
click on the link and access the SAE, you have 60 days to take the exam. You may exit and enter the exam as
many times as you like until you click on Finish and Grade –at that point access to the SAE will terminate. Once
you have completed the SAE you will receive two reports: a score report by major content area so that you can
determine if you have a weakness somewhere; and a report with the questions you got wrong and an explanation of the correct answer.
The cost of the SAE is $35 and you must use a credit card to purchase it, as it is a web-based product. You
can access a link from the ABTC website at http://www.abtc.net/exams.html. •
ABTC Continues Approved
Provider Program Offers
The ABTC Board of Governors has approved extending the free offer for Approved Provider Status for Trans-
plant Centers who have five transplant nurses successfully earn the CCTN credential in the 2009 calendar year.
The American Board for Transplant Certification (ABTC) is offering a once in a lifetime chance. If your transplant
program succeeds in certifying at least five transplant nurses (CCTN) between January 1 and December 31,
2009 your program will receive one year’s worth of free approved provider status for the 2010 calendar year.
With an unlimited amount of CE credit you can offer your staff, you can minimize staff travel expenses – a
$1,500 savings!
For more details on the types of CE you can offer visit the ABTC website at http://www.abtc.net/ceptc.html The winners must complete the application form and meet the requirements in order to qualify for the free
approved provider status. ABTC will be tracking each of the candidates in order to determine what programs
succeed, so be sure to have your staff include the center name on the application form.
Because of the current state of the economy, the board felt that it is more important than ever to help
transplant professionals maintain certification. This free offer helps programs provide continuing education for
less money by being able to offer Category 1 credits onsite at their facilities. For more information on this free
offer, please visit the ABTC or ITNS website. •
ABTC Moves Forward with
Certified Transplant Preservationist Examination
The Board met in Kansas City in March and made some significant decisions regarding the examination for
organ preservationist.
1. The Board approved the examination content that was derived from the committee-based practice analysis.
2. The Board approved the credential designation – Certified Transplant Preservationist (CTP).
3. The Board approved the eligibility qualifications and recertification requirements for CTP:
Eligibility: Must have one full year’s work experience (twelve continuous months) in organ preservation
Recertification: every three years with 60 CEPTCs of continuing education or re-examination
4. Examination fee set at $425 and will be administered in assessment centers.
The Board has requested of the committee that the examination be available by early fall 2009. The CTP
Committee is working diligently to make that happen. Initially, we will not be able to provide instant scoring
results as we currently do with CCTN, so individuals will receive a provisional score report until we have enough
responses to validate the passing point that the committee has set. We cannot give you an estimated timeframe for when instant scoring will begin, as it is dependent on how quickly and how many individuals sit for
the examination once it is launched. If you have employees that qualify now for the examination and you would
like them to test, please encourage them to do so shortly after we launch so that we may implement instant
scoring as quickly as possible. •
ITNS
2009 ITNS
Board of
Directors
Clare Whittaker, RN, BSc [HONS]
President
The Royal London Hospital,
London, UK
Senior Clinical Nurse Specialist
[email protected]
Beth Kallenborn, RN, BSN, CCTC President-Elect
University of Pittsburgh Medical Center
Clinical Transplant Coordinator, Liver Candidate
Service
[email protected] Patricia G. Folk, RN,BSN,CCTC President Emeritus
Starzl Transplantation Institute, University of
Pittsburgh Medical Center
In-house Clinical Coordinator/Patient Educator
[email protected]
Bonnie Potter RN CCTC
Treasurer
Liver Transplant Coordinator
Mayo Clinic
[email protected]
Lynette Fix, RN,BAN,CCTC
Secretary/Web Director
Mayo Clinic
Kidney Transplant Coordinator
[email protected]
Chris Shay Downer, RN, BSN, CCTC
Director Chapter Development
Cleveland Clinic
Intestinal Transplant Coordinator
[email protected]
Michelle James, MS, RN, CNS, CCTN
Director Education
University of Minnesota Medical Center, Fairview
Solid Organ Transplant Clinical Nurse Specialist
[email protected]
Fiona Burrell RN
International Director
Royal Prince Alfred Hospital, Sydney, Australia
Living Transplant Clinical Nurse Consultant
[email protected]
Christiane Kugler, PhD, RN
International Director
Hannover Medical School,
Hannover, Germany
Thoracic Transplantation
[email protected]
Tammy Sebers, RN, BSN, CNN
Director Marketing
Oregon Health Sciences University
[email protected]
Renee Bennett, RN, BSN, CNOR, CCTN, CCTC
Director Newsletter
Cleveland Clinic
Clinical Manager
[email protected]
Cynthia L. Russell PhD, RN,
Director Research
University of Missouri, Associate Professor
[email protected]
Beth Kassalen, MBA
ITNS Executive Director
ITNS Headquarters
[email protected]
ITNS
12
Portrait of an ITNS Chapter:
The UK and Ireland Chapter
The UK and Ireland Chapter was chartered in
2001 at the ITNS Annual Symposium in Cambridge.
We currently represent 60 nurses from 25 renal units
and eight liver and eight cardiac units throughout our
two countries. We do not charge any local chapter
fees. If a nurse from the UK or Ireland is a member of
ITNS they are a member of our chapter.
Although the Chapter was formed in 2001 it took
a few years to get established and focused. We were
fortunate to have Tracey Dudley, Clare Whittaker and
Grainne Walsh on the committee. They all at one
time served on the International Board of Directors.
This enabled us to focus the needs of our chapter.
Without their motivation, dedication and commitment, the chapter could easily have fallen away.
The current President of the UK and Ireland
Chapter is Moira Perrin, a liver recipient transplant
coordinator in Birmingham. Supporting Moira is our
Secretary Joanne Routledge and Treasurer Sherrie
Panther. We have three other committee members,
Anto Ajithpaul, a staff nurse, Michelle Clayton, a lecturer in hepatology and Clare Whittaker, the current
ITNS president. Currently the majority of the committee work in liver transplantation so it is important
that we think of the needs of our renal, cardiac and
pediatric nurses.
In the UK and Ireland, a big investigation took
place into the future of organ donation and transplantation in the UK. The recommendations made
were approved by the government. This has led to
restructuring of organ donation and transplantation.
Donor coordinators will be independent to the transplantation process, (similar to the US procurement
teams) with the benefit that this will lead to a 50%
increase in organ donors over the next five years. In
response to this, there is an increase in the number
of newly created roles for recipient coordinators and
transplant nurses. Our chapter has had calls from
newly appointed transplant nurses/coordinators
that are using us to network and find out more about
transplant nursing. We are thinking of trying to facilitate networking through a chapter email system. We
are also looking towards a generic course for nurses/
coordinators that work in transplantation.
The first European ITNS meeting was held in London, the planning of the meeting supported by the
UK and Ireland Chapter members with many of them
presenting or facilitating discussions. For the past
three years we have worked with the British Transplant Society in supporting and running the nurses’
session at their annual meeting.
We hold an annual study day in the autumn and
we are planning a study day in the North of England
in November. We would love to increase our profile
membership and are going to try to aim to have
100 ITNS members by 2011 (The 10th year of our
Chapter). We are constantly trying to raise our profile
amongst the transplant unit and we were recently
featured in the UK Transplant Bulletin.
Tip
Get a good team of motivated members to form committees and recognize the strengths of all the team.
Advice
Keep with it. We had a few rough years – yes it is
hard work but you will get there. Use the Chapter
Director for support and the headquarters staff as
needed. Know that we are here to support you. •
The ITNS Newsletter is published by
the International Transplant Nurses
Society 1739 E. Carson Street
Box 351, Pittsburgh, Pennslyvania 15203-1700, USA
+1-412-343-ITNS (4867)
Fax: +1-412-343-3959
Email: [email protected]
Articles should be submitted to Renee Bennett,
clinical editor, ITNS Newsletter. Email submission is
preferred at [email protected]. Deadlines for receipt
of materials are as follows: February 15, June 15,
and October 15.
Research reported in the ITNS Newsletter has
not been peer reviewed. Findings and opinions are
the authors’ only.
© All rights reserved. Copyright ITNS. No portion of this publication may be reproduced without
permission in writing from ITNS.
Clinical Editor: Renee Bennett
[email protected]
Managing Editor: Holly Rudoy
Designer: Christopher W. Jones
Advertising
Classified advertising is available in the ITNS Newsletter. Copy should be typed and double spaced.
Classified ads will be accepted at any time and
will be placed in the next newsletter if possible. A
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Contact ITNS Executive Director, Beth Kassalen,
at 412-343-ITNS (4867) regarding fees for display
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Please recycle.
ITNS Events Calendar
2009
Sept. 23
ITNS Board of Directors Meeting
Montreal, Quebec Canada
Sept. 24-26
ITNS 18th Annual Symposium
“The Joy of Transplant Nursing”
Montreal, Quebec Canada
Oct. 1-3
ITNS Exhibit: ANCC Magnet
Conference
Louisville, Kentucky USA
Oct. 13-16
ITNS Exhibit: Society for Transplant
Social Workers
Cleveland, Ohio USA
Nov. 2-4
ITNS Exhibit: Contemporary Forums
– Advances in Transplantation
San Antonio, Texas USA
Nov. 13-14
ITNS Board of Directors Meeting
Columbus, Ohio USA
Nov. 14-16
ITNS Transplantation Certification
Review Course
Columbus, Ohio USA
2010
Oct. 28-30
ITNS 19th Annual Symposium “It’s
All About the Patients”
Minneapolis, Minnesota USA
Dec. ITNS Board of Directors Meeting
Pittsburgh, Pennsylvania USA
Feb. 10-11
ITNS Board of Directors Meeting
San Antonio, Texas USA
Feb. 12-13
ITNS Winter Workshop “Quality and
Best Practices in Transplantation”
San Antonio, Texas USA
June 16-17
ITNS Board of Directors Meeting
Berlin, Germany
Sept. 14
ITNS Board of Directors Meeting
Goteborg, Sweden
June 18-19
ITNS European Conference
“Transplantation: Improving Patient
Outcomes”
Berlin, Germany
Sept. 15-17
ITNS 20th Annual Symposium
Goteborg, Sweden
Oct. 27
ITNS Board of Directors Meeting
Minneapolis, Minnesota USA
Dec. ITNS Focus on Pediatric
Transplantation
Pittsburgh, Pennsylvania USA
2011