Advances in data mining may find potential candidates earlier so they get the right care at the right time.
Transplant science has made great strides since it was pioneered at a handful of medical centers in the 1980s, including UPMC. Today, new protocols and state-of-the-art immunosuppression therapies are expanding the donor pool, enabling hospitals worldwide to routinely perform operations that were impossible just a short time ago.
But barriers remain, particularly in an environment of constant donor shortages. One critical challenge is to extend the effectiveness of transplants through the early identification of candidates who ultimately will need a transplant, so their health may be properly managed in order to achieve the most successful outcome possible.
Using High Tech Tools to Find Transplant Candidates
Scientists at UPMC’s Thomas E. Starzl Transplantation Institute are pushing the envelope on this front with a new tool: Big Data — the same technology that industries use to run supply chains and find new customers. In the case of heart transplantation, the analysis is based on medical factors, symptoms, doctor visits, and lifestyle choices.
Leading the effort is a team of UPMC researchers that includes heart transplant surgeon Christopher M. Sciortino, MD, PhD, FACS. The team is exploring UPMC’s network of patients to find new ways to bring heart transplant candidates into the treatment process earlier. “We want to identify patients in our hospital system who would benefit from referral for advanced heart failure management, including evaluation for transplant, in the hopes of supporting and caring for them when they’re at a higher level of health,” says Dr. Sciortino.
The Right Treatment at the Right Time
Why is it important to reach and treat patients earlier? “Our program here at UPMC tends to see a relatively higher proportion of acute end-stage heart failure patients,” says Dr. Sciortino. Many of these patients already have experienced a gradual decline in health before they are referred to the transplant team. Using medical records to identify them before they reach that condition can help doctors define a strategy that prepares them better, introduces them to UPMC’s heart failure experts earlier, and maintains them on their health path for a longer time before they need a transplant. “Most importantly, it could get these patients to us before they become too sick for a transplant,” says Dr. Sciortino.
Better Timing, Potentially Better Outcomes
The team is using a software application developed at UPMC to comb the electronic medical records (EMR) of potential recipients in the UPMC system, applying a variety of filters that include heart function, pacemaker implantation, medications, hospitalization for congestive heart failure, and other factors that can be used to predict the need for transplantation. “After it’s refined,” says Dr. Sciortino, “when patients hit certain criteria, we could have a system in place that will enable us to flag their primary cardiologist, designated family member, UPMC, or other appropriate sources to advise them that it’s now time to schedule an appointment with us.”
A Natural Fit
Advanced data analysis for transplantation is a natural fit for UPMC, where organ transplantation first made great strides through the pioneering research of Thomas E. Starzl, MD in the 1980s. UPMC is one of a handful of hospitals with the resources and experience to perform all types of transplants, including high-risk operations, plus the data mining capabilities to reach new recipients. “We are a progressive center,” says Dr. Sciortino. “We don’t want to have to say to someone who needs a transplant, ‘you’re too sick for us to help you.’ That’s what this work is all about.”