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Chicago transplant program caters to Hispanics

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NEW YORK -- Dr. Juan Carlos Caicedo sounds proud when he reads the statistics: Kidney transplants for Hispanics have almost doubled at his Chicago hospital, and some of the patients come from as far away as Puerto Rico, Texas and Florida.

The reason? They are all interested in the only known transplant program in the United States conducted entirely in Spanish and tailored to the unique needs of Hispanic patients.

The clinic offers care in a "culturally-sensitive manner" to the largest minority population in the United States, proponents of the program say.

"I realized there was a big Hispanic community that was not receiving the attention it needed," said Caicedo, a transplant surgeon and director of the program at Northwestern Memorial Hospital. "Something that really surprised me was hearing a patient say that he had called 10 different transplant centers, but because they all answered the phone in English, he would hang up. He was scared."

The program began in December of 2006 and since then the number of kidney transplants in Hispanic patients at the hospital has grown from 22 in 2005 to 41 so far this year. The clinic is now expanding to include liver operations.

Such specialization showcases the need to attend to a growing ethnic minority with a high incidence of obesity, Hepatitis C and Hepatitis C, all of which can lead to organ transplantation, Caicedo said.

There are more than 90,000 people on the waiting list to get a kidney in the country. Of those, nearly 16,000 are Hispanic, said Ellie Schlam, director of external communications for the National Kidney Foundation.

About 11 percent -- or five million -- of the 47 million Hispanics in the country have diabetes, added Schlam. "And about one-third of the cases of diabetes in Hispanic Americans are undiagnosed," she said.

Anybody with kidney or liver problems who arrives at Northwestern Memorial and prefers to be attended in Spanish is directed to the program. Seventy-five percent of Hispanic patients prefer to be attended in Spanish, said Caicedo, who was born in Bogota, Colombia.

A patient will not move up on a transplant waiting-list by entering the program: it merely offers specialized attention to Hispanic families, in which "sometimes the grandmother is the one who will give the blessing to go ahead with an operation," said Caicedo.

The clinic has 24 staff members -- nurses, nephrologists, cardiologists, social workers and accountants, among others -- who speak Spanish. It also offers educational sessions in Spanish "where entire families can be present to learn about the disease and treatment options," the hospital said in a statement in August, when it announced its expansion to include liver transplants.

Hispanics rank second on the wait list for liver transplants, according to the United Network for Organ Sharing (UNOS).

So far, about 170 patients have been attended by the Hispanic Transplant Program, not all of them requiring the operation, said Caicedo.

Amparo Cossio, a 68-year-old Mexican immigrant, was told she needed a kidney transplant. Her son chose the hospital because Cossio, who suffered diabetes and kidney failure, understood better Spanish than English. After being on the wait list for a month, doctors told Cossio that her niece Maria Antonieta could donate her kidney to her.

"I knew about doctors who worked on this program and who spoke Spanish," said the retiree, who was born in San Luis de Potosi and worked for years as a clerk in shopping stores in Chicago. "I felt good. They would tell us in Spanish how everything worked, and there I learned about my relatives having to do tests to see if we were compatible."

The operation occurred in August 2009. Cossio said she is fine, but still recovering.

Estanislao Garcia, 63, was diagnosed with cancer and liver cirrhosis. After nearly two years on the wait list, the Mexican immigrant and father of five received a liver at the hospital from a dead donor a few months ago.

His wife Adelita, 53, said they met four Spanish-speaking doctors, including Caicedo. "That was a relief for me. It helped us," she said.

A transplant costs tens of thousands of dollars. Patients who join the program normally have medical insurance to cover costs of the treatment and the transplant.

But the situation can be very different for some low-income immigrants.

Low income Hispanic immigrants, especially if undocumented, might not have the means to cover medical expenses, which means they are not able to access the waiting list to get a new kidney or liver.

In the midst of a debate over immigration reform and recently approved health care reform, some experts wonder if it would be worth paying for transplants for undocumented immigrants, instead of keeping them on expensive dialysis treatments covered by taxpayer money.

"It would be cheaper. In two years the operation would be covered, and the government would save more than with dialysis," said Raiza Mendoza, coordinator of Hispanic outreach for the non-profit Gift of Hope, Organ and Tissue Donor Network, in Illinois.

Mendoza said Hispanics historically do not donate organs at high rates, so she tries to "inspire" them to become donors.

"It was very intelligent to offer a transplant program in Spanish. Hispanics are shy when it comes to confronting a language they don't know about," she said. "This has been incredibly positive."


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