Carilion Clinic wants to launch a kidney transplant program; UVA Health opposes it

In the coming weeks, Carilion Clinic will learn whether it has the go-ahead from the state to launch a kidney transplant program at Carilion Roanoke Memorial Hospital, a plan UVA Health has publicly opposed.

The Roanoke-based health system’s pitch for establishing a program is that there is no kidney transplant surgery available in the southwestern part of Virginia, and the State Medical Facilities Plan states that transplant services should be “accessible within two hours driving time one way.”

 “We want to make it easier for the 79% of transplant patients in Southwest Virginia who must drive two to four hours to get to the nearest transplant center to get the care they need,” Carilion Clinic said in a statement. 

Meanwhile, UVA Health maintains that more than 1,100 patients from Southwest Virginia have received organ transplant surgeries since 1997 at its Charlottesville-based Charles O. Strickler Transplant Center, and that it has outpatient services in the Southwest region for transplant patients.

In a letter to the state last year, UVA raised several objections to Carilion’s plan, including a concern that it would pull patients from UVA Health, and the Certificate of Public Need staff in late February recommended that the Virginia health commissioner, Dr. Karen Shelton, deny Carilion’s request.

After an informal January hearing and the Feb. 28 closing of the adjudicatory record, Shelton had 45 days to issue a decision, but she extended the deadline to May 9, which is permitted under state law, a spokesperson for the Virginia Department of Health said Thursday.

Meanwhile, UVA Health emphasized that before and after surgery, patients receive care at outpatient transplant clinics run by UVA Health across the state, including a new clinic in Wytheville that opened in March, focusing on kidney, lung and liver transplants.

Offered in partnership with Wythe County Community Hospital, the Wytheville transplant clinic allows patients to be seen monthly at a site adjacent to the hospital, receiving testing and consultation before surgery and post-surgery care.

In addition to the new Wytheville transplant clinic, UVA Health offers similar clinics in Martinsville, Roanoke, Lynchburg, Norfolk, Newport News, Richmond, Arlington and Charlottesville.

“Based on data from the federal Census Bureau and the national Organ Procurement and Transplantation Network, patients from Southwest Virginia who are eligible for kidney transplants receive transplants at the same rate as eligible patients in Northern Virginia,” the Charlottesville-based health system said in a statement. 

“These outpatient clinics are particularly important in kidney care because 90% of a kidney transplant patient’s care is provided on an outpatient basis,” UVA Health added. “Carilion’s proposal only initially calls for a single outpatient clinic in Roanoke, raising concerns about access to outpatient care to the rest of Carilion’s anticipated kidney transplant patients residing in the service area.”

UVA Health stated these and other points in an opposition letter that was included in a May 2024 analysis of Carilion’s proposal to the state to start a transplant program in Roanoke. Under Virginia law, the state’s Certificate of Public Need staffers evaluate health systems’ proposals for new hospitals and other medical services and make recommendations to the state health commissioner.

Among the factors listed by COPN staff was that a Carilion kidney transplant program “could negatively impact existing providers of kidney transplant services.”

If approved in May by Shelton, Carilion’s kidney transplant program would become the seventh in the state and would use an existing operating room at Carilion Roanoke Memorial Hospital and establish an outpatient clinic at a nearby office. The health system projects the capital cost for the transplant program to be $150,000.

From 1993 to 1997, Roanoke Memorial Hospital, as it was known then, performed 73 kidney transplants, according to the 2024 analysis, but the program ended after the transplant surgeon resigned.