UC Davis Transplant Center expands access to life-saving liver care for veterans

The Sacramento VA Medical Center and UC Davis Health are transforming access to liver transplants for veterans in Northern California - dramatically increasing the number of patients able to receive this life-saving care.

By launching its liver transplant program in July 2023, the UC Davis Transplant Center greatly expanded access in a region long challenged by limited availability. Since then, a growing number of patients have received care, including 11 from the Sacramento VA who successfully underwent liver transplant at UC Davis Health. That's nearly triple the number of area veterans who had to travel outside of the Sacramento region for transplants in the previous four years combined. During that time frame before UC Davis starts its program, 2020 to 2023, just four patients from the Sacramento VA received transplants.

This rapid progress underscores the power of collaboration between VA providers and academic medical centers.

"The collaboration is successful because the lines of communication are open," said Vikrant Rachakonda, chief of hepatology at the VA and associate professor of Gastroenterology and Hepatology at UC Davis Health. "Our teams are in constant dialogue - from initial referral through post-transplant care - which allows us to move quickly, coordinate seamlessly, and ensure veterans aren't falling through the cracks. By working together, we're able to remove barriers that once delayed or prevented access to life-saving transplants, and that's making a real, measurable difference in patients' lives."

Meeting a critical need for veterans with liver disease

The impact of this partnership is especially important given the scale of liver disease within the veteran population.

Veterans experience disproportionately high rates of serious liver conditions, including advanced liver disease and hepatocellular carcinoma, the most common form of liver cancer. VA enrollees are estimated to be five times more likely than civilians to develop this disease, driven in part by higher rates of hepatitis C, metabolic syndrome and obesity.

Despite the high burden of disease, access to liver transplantation within the VA system has historically been limited. The Veterans Health Administration performs liver transplants at just six specialized VA Transplant Centers nationwide. Only one of these centers is located west of the Rocky Mountains, in Portland, Oregon.

The U.S. Department of Veterans Affairs operates the largest integrated healthcare system in the nation and serves as the largest provider of care for patients with liver disease.

The Sacramento VA Medical Center, at the former Mather Air Force Base, is one of the largest in the country. But it, too, faces the constraints of the VA system nationwide, which makes the expanded access through UC Davis Health especially meaningful for local patients.

A relationship that thrives on clear communication

A key strength of the partnership lies in its integrated, team-based approach to care. VA clinicians are directly involved in the transplant process at UC Davis Health, ensuring continuity and coordination at every stage.

"The nice part of my role is that I'm able to be an advocate for our VA patients in the UC Davis transplant program," Rachakonda explained. "I participate in the selection committee and help communicate directly with patients and providers within the VA system. That allows us to identify and address any barriers to transplant candidacy early on."

This close collaboration extends across teams - from VA nurse managers and liver clinic staff to UC Davis transplant coordinators - helping streamline care and keep patients on track.

"We're able to convey the concerns of the selection committee back to our VA providers and patients so we can address any issues," Rachakonda added. "There's a lot of open communication, and that makes a big difference."

Innovation expands access to transplants

In addition to improved coordination, UC Davis Health's advanced clinical approach is helping increase transplant availability and improve outcomes. Compared with national averages, UC Davis performs liver transplants at a markedly faster pace, leading to shorter wait times.

Data from the Scientific Registry of Transplant Recipients shows UC Davis Health is performing nearly four transplants per patient per year, compared with approximately 1.2 nationally.

"This higher transplant rate translates into substantially shorter wait times, allowing patients to receive life-saving transplants sooner," said Lea K. Matsuoka, section chief for liver transplantation and hepatobiliary surgery at the UC Davis Transplant Center. "Reducing time on the waiting list is critical, and faster access to transplantation directly supports better patient outcomes."

This success is driven in part by the use of innovative liver perfusion technology, which preserves and optimizes donor organs that might otherwise go unused - expanding the donor pool and increasing transplant opportunities.

"The utilization of machine perfusion technology has allowed us to transplant at a rate above the national average," Matsuoka said. "As a result, we have achieved some of the best transplant waitlist survival outcomes in the country, offering new hope to our patients - including veterans - who might otherwise face long waits or limited options."

A powerful model for the future of veteran care

The partnership between the Sacramento VA and UC Davis Health demonstrates how collaboration can expand access to life-saving care. By aligning expertise, improving coordination and prioritizing patient-centered care, the two institutions are creating new pathways for veterans to receive timely, advanced treatment.

As liver disease continues to affect veterans at disproportionately high rates, innovative programs like this one offer a powerful model for bridging gaps in care and ensuring that more veterans receive the procedures they need and deserve.

"It truly is a pleasure and an honor to take care of people who have sacrificed so much for our country," Rachakonda said. "That's why I stay at the VA - I love the patients. You're humbled by what they've gone through and the selfless way they've served. Providing exceptional care is the least we can do."