- June 16, 2025
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In 2022, Tampa General Hospital, already a top-five hospital in size with 1,040 beds and the 17th largest in the nation, set its sights on what Dr. Kiran Dhanireddy, vice president and chief of the TGH Transplant Institute, called two "big, hairy, audacious" goals: to be the largest transplant center in the country and to perform 1,000 transplants in one year.
A little more than two years in, the hospital has met one of the two benchmarks, becoming the largest transplant center nationwide, with 889 transplants in 2024: 500 kidneys, 279 livers, 51 hearts, 42 lungs, 14 pancreas and 3 heart-lungs combined. TGH moved up to No. 1 on the national transplant list from No. 4 in 2023, surpassing Mayo Clinic Hospital Arizona, University of California San Francisco Medical Center and The Cleveland Clinic Foundation. The data comes from the Organ Procurement & Transplantation Network.
The TGH transplants were performed by 40 physicians and supported by 200 team members in the Transplant Institute, plus hundreds of others in the hospital system involved in transplant patient care.
The work was made possible in part with a strong embrace of technology. For decades, organs have been transplanted similarly to how one might carry beer to the beach: stuffed in a consumer-grade cooler full of ice and preservation solution.
“What's been realized over the last decade or so, and really accelerated over the last few years, is that ice actually causes injury to the organs during transportation, and so we are now using an advanced preservation device developed by Paragonix and they have a regulated, advanced hypothermic storage device that's much more sophisticated than a Coleman cooler, and it keeps the temperature the organ very regulated, ” Dhanireddy says.
On the opposite end of the temperature-controlled storage spectrum, normothermic machine perfusion, which is the maintenance of an organ at body temperature with blood pumping through it, keeps organs continually functioning outside the body — a heart continuing to pump blood, a liver continuing to detoxify blood — during transportation of the organ.
These advances have multi-pronged benefits to the business of organ transplantation. By realizing a better standard of care during transport, organs are able to survive longer outside the body, which cuts down on travel costs substantially. It also allows for organs to be brought in from further places, as far as California, which was never possible before.
For example, a donated liver may last only a few hours on ice but on a normothermic machine perfusion (NMP) device it can potentially last up to seven days.
“We just got a liver from Miami and that was driven across the state. Historically, we would have spent about $12,000 to $15,000 flying that organ on a private jet, and now we spent about $1,000 driving it. So we utilize the technology for the benefit of the patient, but also to mitigate some of the costs,” Dhanireddy says.
For liver transplant recipients like Kimberly Toole, it is the difference between life and death. In 2019, she had spent months not feeling well. Her sister visiting for the holidays encouraged her to go to the hospital after she saw Toole’s home undecorated. (Toole’s first job out of college was working for Martha Stewart, so the absence of Christmas cheer was a serious sign that something was wrong.)
She collapsed at the hospital with multiple organ failure — including genetically-linked liver cirrhosis — and at 39 years old was given three weeks to live. Although she eventually stabilized, she kept being given short increments of time to live and doctors in her Texas town did not see transplantation as a viable option.
Toole, raised in Tampa Bay, decided to come home. “I said, ‘This is it.’ I was like, ‘I want to be in my happy place. I want to have a view from my bed of the Gulf of Mexico. I want my last steps to be in the sand,” Toole recalls.
After a rough time with her symptoms in 2023, she was admitted to the emergency room at TGH. A hepatologist (liver doctor) came into her room, Toole says, and asked if anyone had ever talked to her about a liver transplant, saying, “Would you like a new liver?” With tears in her eyes she responded, “Yes! Where do I sign?”
On Jan. 16, 2024 — five months after that first offer, with patients potentially waiting up to five years — she received a liver transplant.
“They saved my life.I would have already been dead by now. It was a tough recovery, but I'm doing great now,” she says.
Attention to patient care like that can also be credited, in part, to technology. TGH began partnering with Palantir Technologies in 2021 and officially selected the firm’s AI-powered software for its patient care coordination.
“So health care is full of data, right? We've been data rich in health care since the mass introduction of the EMR, the electronic medical record. But developing the insights out of that data has been challenging because the data aren't in the medical record in a way that's easily extracted,” Dhanireddy says. “So AI is really a highly useful tool to help with clinical decision making. For example, we've got a pilot in heart failure using artificial intelligence for determining the right care pathway for patients and adherence to that care pathway so that they can reduce the number of times they're readmitted to the hospital.”
Streamlining the administrative tasks of physicians and having the ability to procure more organs with a less stressful time window is crucial for patients and doctors.
Flexible operation windows mean daytime transplantation and therefore less fatigue on doctors who might be summoned from their sleep to perform an operation at 2 a.m. Dhanireddy says there hasn’t been a nighttime liver transplant since September 2023.
This is an important step in potentially closing the gap of Florida’s physician shortage. A 2024 Florida TaxWatch report notes that in 2021, Florida’s supply of family medicine physicians, general internal medicine physicians and pediatric physicians was only enough to satisfy 71%, 62%, and 94% of demand, respectively. Although there is an increase in physicians, it is not enough to outpace the growth in population. It is suggested that Florida will need to fill 22,000 vacant positions by 2030.
Looking toward the future, Dhanireddy is keeping an eye on technology that will continue to simplify organ transplantation. One such trend is xenotransplantation — more specifically, organs from genetically modified pigs. “Not your typical farmed pigs,” the porcine critters are raised in a tightly controlled environment to prevent infection and modified to eliminate some of the characteristics, proteins and carbohydrates on their cells that cause negative human immune system reactivity. Having this availability in donor supply could potentially save thousands of lives, which is where the joy of the work comes from, according to Dhanireddy.
“This is the most exciting moment of my career, because of the introduction of new technologies, because I feel incredibly privileged to work in an organization that's so supportive of our mission to transplant more people,” he says, “We said we're going to do 1,000 transplants. And people laughed that it wasn't possible, that it wasn't possible for us at Tampa General to do it, or that there would never be enough organs to do 1,000 transplants. And what I'm most excited about is the ability to think boldly in the service of our patients and community.”
