Maggie McKay (Host): This is Community Connect: presented by Tampa General Hospital. I'm your host, Maggie McKay. Joining me is Dr. Kiran Dhanireddy, VP and Chief of the Transplant Institute at Tampa General Hospital. Thank you so much for being here today.

Dr. Kiran Dhanireddy: Thanks a lot for having me, Maggie.

Host: Of course. How big is the need for organ donation today? And what does that look like for people who are waiting for a transplant?

Dr. Kiran Dhanireddy: So, the need for organ donation is overwhelming. On a daily basis, there are over a hundred thousand people in the United States awaiting the generous gift of an organ donor so that they can have a life-saving transplant operation that's necessary for them. And in the state of Florida where we're located, over 6,000 people are waiting and over 1200 people on the list here at Tampa General Hospital. So, we are constantly looking for ways to provide more organs available for transplant.

Host: Most people think of organ donation as something that only happens after someone passes away, but living donation is becoming more common. Could you please explain how living donation works and why it's such an important option, especially for kidneys and livers?

Dr. Kiran Dhanireddy: One of the ways that we try to fill the gap between the patients that need transplant and the organs available is through living donation. And the majority of living donation in the country is for kidney transplant. And last year, we did 123 living donor kidney transplants and you have two kidneys. And so, when the donor gives up one kidney, the remaining kidney actually is able to compensate and allow them to have a healthy life afterwards.

We also do living donor liver transplant here at Tampa General Hospital. And last year, we did 12. And in that operation, since you only have one liver, we actually have to divide it. So, we divide the liver and give about two-thirds of the donor's liver to a recipient in need. And the remarkable thing about the liver is that it regrows on the side of the donor to the size that the donor needs, and then the portion that's in the recipient also grows to the size that the recipient needs. Pretty remarkable organ.

Host: That's wild. A lot's changed in transplant medicine over the years. What are some of the advances you think have made the biggest difference for patients?

Dr. Kiran Dhanireddy: The historical way of transporting an organ from a donor hospital to a transplant hospital was in preservation solution under ice in literally a Coleman or Igloo cooler. And the recent advent of new technology to preserve an organ longer and actually allow it to function outside of the body is transforming the field.

We are leading those efforts here at Tampa General Hospital. And we have the world's largest experience in this new technology called normothermic machine perfusion. And just to break it down, that is where we actively pump blood through an organ that is outside of the human body and awaiting to be transplanted. And what this technology allows us is it allows us to transplant organs from farther away. For example, we transplant livers from California, from the Midwest. And this was historically not possible when we were transporting organs with ice.

Additionally, we are able to determine if the liver is functioning well prior to doing the transplant, and this makes the operation safer for patients. We have radically expanded the pool of organs available for transplant, and that's really part of the key behind the growth in our transplant Institute, one of the largest in the country.

Host: We hear more about new technologies that help preserve and protect organs before transplant. In simple terms, what are these innovations doing and how are they changing what's possible? I know you touched on it a little bit with the transportation, but in general.

Dr. Kiran Dhanireddy: Yeah. So in the past, we would restrict our consideration of organ donors to people who didn't have a lot of medical problems or people who were not in significant traumas or injuries so that we could assure that the organ that was donated was going to function well in the recipient. With these new technologies, we can really open the door for lots of people to be considered for organ donation that wouldn't have necessarily been considered in the past.

In fact, last month, we transplanted a liver from a 91-year-old donor. And the oldest donor that's been utilized is over a hundred. And so, these were not organs that would've been considered without the use of this new technology. And in respecting the gift of the organ donor, we really want to make that opportunity available to more and more people. So, the technology really helps both organ donation as well as transplantation.

Host: I can't believe that a person over a hundred could be a viable donor at that age.

Dr. Kiran Dhanireddy: Yeah, we really wouldn't have considered it in the past.

Host: When you look ahead, what excites you most about the future of transplantation and where do you see things going next?

Dr. Kiran Dhanireddy: This is a really exciting moment for transplantation and for the transplant institute at Tampa General Hospital. Everything we do is really in service of our community. And the community of patients that need transplant are the sickest and sometimes most needy paatients. And with utilization of new technology and the proficiency of our expert team, we are adding new knowledge to the field all the time. And we're world leaders in machine perfusion of the liver. We are one of the top kidney transplant programs. We're developing new in-house expertise in technology in pursuit of serving the population of patients that need lung transplant as well.

And so, this is an exciting moment because we have historically considered organs scarce. And so, we have had to choose who in our community would be the best stewards of those organs. And now, with these technologies, we have more organs available. And so, we're better able to serve our community in need. And that really wakes me up every morning and gets me excited to come work alongside this fantastic team.

Host: I bet. What do you wish more people understood about the impact of organ donation?

Dr. Kiran Dhanireddy: Well, there are a lot of myths about organ donation. And I think it's important to dispel some of them. First of all, in the state of Florida, about 10 million people are registered donors. And that's a really big number and it is a generous thing for people to sign up to be an organ donor, but that's not even half of the population.

And I think part of the reason that more people don't sign up to be an organ donor is of their concerns about the safety of organ donation. And a common myth is that a healthcare team might give up on someone who's been severely injured or has had a significant illness and focus on organ donation.

And I'm here to say that the priority of healthcare teams is to save people's lives. And only when every avenue has been exhausted do we pivot to the conversation about organ donation. And a single organ donor can save the lives of eight people. And so, we don't pursue that until we know that there's no meaningful chance of recovery for a potential donor in a patient.

Host: Is there anything else in closing that you'd like to add?

Dr. Kiran Dhanireddy: I would really like to appreciate the generosity of organ donors, both deceased and living. It allows me to do the work that we do here at Tampa General Hospital in saving so many people's lives. We've been doing this for over 50 years and over 15,000 transplant operations and patients' lives transformed So, it is a great responsibility and gift to do this work. And so, I'm grateful for the opportunity to highlight it.

Host: Well, thank you so much for sharing your expertise. We really appreciate your time today.

Dr. Kiran Dhanireddy: Thank you, Maggie.

Host: Again, that's Dr. Karen Dhanireddy. To find out more, please visit tgh.org/transplant. If you enjoyed this episode, please be sure to like, subscribe, and follow Community Connect: presented by TGH on your favorite podcast platform. I'm Maggie McKay, and this is Community Connect: presented by TGH. Thanks for listening.