Ben Hippen is a transplant nephrologist who I encountered not too long after I started to think about kidney transplants. I've always found it enlightening to listen to him. And he's changed where he sits, most recently by taking a position with Fresenius, the big dialysis provider.
Here's a snippet of his professional history from his cv:
Current positions:
•Senior Vice President, Global Head of Transplant Medicine, Fresenius Medical Care. Sept 2021
•Clinical Professor of Internal Medicine, University of North Carolina, Chapel Hill School of Medicine. (Non-tenure track appointment) April 2015-present.
Past Positions:
•General and Transplant Nephrologist, Metrolina Nephrology Associates, P.A, Charlotte, North Carolina. 2005-2021
•Attending General and Transplant Nephrologist, Transplant Center, Carolinas Medical Center, Charlotte, North Carolina. 2005 - 2021
•Medical Director, FKC Baxter Street Hemodialysis Unit (in-center and home therapies).2009-2021.
Here are some of his current thoughts, with his colleague Dr. Pascual, in Medpage Today on how to advance kidney care and transplantation.
The Kidney Transplant Ecosystem Is Ripe for Reform— Here are the policies and payment systems that need to change by Benjamin Hippen, MD, and Thao Pascual, MD
"A centralized data repository of patients' clinical evaluations, laboratory, and radiologic testing accessible by multiple transplant centers could reduce the time, expense, and waste of redundant or obsolete testing.
...
"Quality outcomes for transplant programs should be pegged to the patient outcome that really matters: Receiving a successful kidney transplant in the shortest period of time. A recent survey of patients with kidney disease regarding tradeoffs between being transplanted earlier and waiting for a "better organ" confirms that a wide majority of patients prioritize being transplanted sooner. "Transplant soon and well" should be the mantra for regulators and policy makers when considering nephrologist and dialysis provider-facing metrics to achieve the right outcomes for patients.
...
"several reforms can be made to the transplant ecosystem to make it easier for transplant centers to be more aggressive in their organ acceptance behaviors. Changing the organ offer system to use the approach of "simultaneously expiring offers" can streamline organ placement timelines, placing higher-risk organs with more risk-tolerant centers more quickly and efficiently. Aligned with the goal of getting patients to transplant faster, regulators and payors (public and private) should prioritize shortening time to transplant over sky-high 1-year patient and graft survival thresholds. The lowest performing third of transplant centers are conferring longer and better survival rates to patients compared to any maintenance dialysis therapy. We should seek to remove regulatory and financial barriers to transplant centers seeking to safely make use of every gift of life. If we expect transplant centers to transplant higher-risk organs, we should recognize that it may cost more to perform those transplants successfully. The payment system for transplants should account for these higher costs so that transplant centers are not faced with losing money when transplanting higher-risk organs.
"A key component of the kidney transplant ecosystem is the generosity of living donors, and we should do more to support their decision to give the gift of life. This means protecting living donors from insurer efforts to exclude them from life or disability insurance coverage because of their donation. In addition, enhancing education efforts to increase living donor kidney transplants can help bridge the gap between organ need and supply. One pending solution to these challenges is the passage of the Living Donor Protection Act (H.R.1255/S.377). The bill would prohibit discrimination by insurers based on an individual's status as a living organ donor. Employers can also do their part through adjusting their paid leave policies for employees who become living donors, by joining the AST Living Donor Circle of Excellence."
"Benjamin Hippen, MD, is senior vice president and head of transplant medicine and emerging capabilities at Fresenius Medical Care. Thao Pascual, MD, is associate chief medical officer at U.S. Renal Care. They are both members of Kidney Care Partners."
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As a long time, thoughtful observer of kidney care and transplantation, Dr Hippen's point of view has shifted over time. Below are some (much) earlier blog posts featuring some of his earlier thoughts.
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