William C. Jennings, MD, FACS, is a missionary when it comes to vascular access for hemodialysis patients. An emeritus member of the Fistula First Catheter Last (FFCL) access planning committee, Dr. Jennings was part of the Fistula First movement from the first national program on vascular access throughout all the later meetings. FFCL focuses on increasing the use of arteriovenous fistulas (AVFs) for hemodialysis access, and decreasing the use of long-term tunneled dialysis catheters. Dr. Jennings along with Dr. Lawrence Spergel created the FFCL surgeon training videos which reside on the ESRD National Coordinating Center website (click here to view the videos).
A well-known surgeon in the Tulsa, Oklahoma area for many years, Dr. Jennings completed his doctor of medicine degree at the University of Arkansas, College of Medicine, in Little Rock and his general surgery residency at the University of Oklahoma, Tulsa College of Medicine, where he served as a professor of surgery for many years, providing surgical care, teaching, and research. He was also involved for several years with ESRD Network 13 as their surgical representative, training surgeons on vascular access creation and management, in addition to working with surgeons throughout the United States.
“I have always had a great interest in vascular access and caring for patients with chronic kidney disease,” Dr. Jennings said. He is still very active in training vascular access surgeons and working with the residency program at the University of Oklahoma, Tulsa College of Medicine.
Dr. Jennings has begun another chapter in his work with vascular access, leading surgical mission trips for Bridge of Life, the primary program of DaVita Village Trust, a not-for-profit program that brings dialysis equipment and training predominately to third world countries. Among other health care activities, Bridge of Life establishes dialysis units with fully reconditioned dialysis equipment; providing training, support, and expertise in partnering with local health care providers. Dr. Jennings became involved with Bridge of Life when they began to receive requests for help with fistula creation, training, and management.
“Developing countries may or may not have a higher rate of kidney failure [than others] but [they do] have higher mortality rates because treatment is often not available,” Dr. Jennings said. The Bridge of Life surgeons create AVFs and train local surgeons during each trip. Three surgical mission trips to Jamaica and a pediatric mission to Guatemala have been completed, with another trip planned for December. “We take ultrasound [equipment] with us, because [local care givers] often have little or no access to it,” he said. “We work with the surgeons, establishing trust, respect, and friendship. They are very thoughtful, caring, and skilled physicians.”
Dr. Jennings brings FFCL materials with him on every trip to share with physicians, nurses, dialysis personnel, and other caregivers. The surgical team trains clinical staff on how to create fistulas, and teaches them how to monitor fistula health. The goal is to equip these clinicians so they can, in turn, teach other professionals, patients and care partners. “I was pleased to find a lot of the resources available in Spanish,” he said of a recent trip to Guatemala. “I bring copies of our publications and videos on a thumb drive for the local nephrologists and surgeons wherever we’re going, with the expectation they will spread the resources among their colleagues.”
Having been a major part of the movement to increase fistula rates in the U.S., Dr. Jennings finds it satisfying to carry the mission into other countries in need. “In Jamaica the fistula rate was up to nearly 80 percent last year and we feel it will be even higher when re-evaluated next year,” he said.
Ask the Experts is a continuing series of profiles and interviews, focusing on topics of interest to professionals in the kidney community.
The photo above shows a Bridge of Life mission.