by Elizabeth Ann Miller, health and wellness reporter
Carilion Clinic is fighting to provide Southwest Virginia its first kidney transplant program, bringing life-saving care closer to home. The biggest obstacle remains support from state regulators.
Southwest Virginia is one of the few regions in the state without a kidney transplant center, forcing patients to travel up and down the east coast to facilities in Richmond, Charlottesville, or North Carolina. Carilion Clinic believes a local program would limit that burden and save more lives. However, the proposal lacks support from select state regulators. This hurdle highlights the broader challenges in providing specialized medical care to rural communities, where patients often face long wait times and logistical barriers to treatment.
According to a report by Cardinal News, The Roanoke-based health system defended its proposal during a four-hour hearing in Richmond. Eight individuals, including a kidney transplant recipient, Joey Shervey, spoke in support. The state’s Certificate of Public Need division recommended denying Carilion’s request, raising concerns expressed by the University of Virginia (UVa), which currently operates the only transplant center in the region.
Patient Struggle
Joey Shervey spoke during the hearing to represent local patients. At 28, Shervey has already endured the emotional and financial burden of kidney failure and transplant. He was diagnosed with Stage 5 kidney failure at 26. Throughout the treatment and transplant process, Shervey and his wife, Jessica, were living in Roanoke. Appointments required them to frequently make the nearly two-hour drive to Charlottesville, straining their finances, careers, and daily lives. During the hearing, Shervey expressed that for patients like him, Carilion’s proposal represents a shot at a better life.
“I’ve become the person I did not want to be. I am a 30-year-old man living in my parents’ basement. That’s not the goal I want to set for my future family,” Shervey said during his testimony.
The Sherveys traveled to Richmond to advocate for Carilion’s proposal, hoping future transplant patients in the region won’t face the same struggles. Jessica Shervey took on the role of primary caregiver and spoke about the sleepless nights, constant travel, and anxiety that came with her husband’s health crisis.
Opposition and Support
UVa is the only health system opposing Carilion’s plan, arguing that the biggest barrier to kidney transplantation is the limited availability of donor organs in Southwest Virginia. In their opposition letter, UVa noted that it already operates outpatient transplant clinics in Roanoke, Martinsville, and Lynchburg, allowing Southwest Virginia patients to receive most of their care closer to home.
Dr. Marlon Levy, CEO of Virginia Commonwealth University (VCU) Health System and Senior Vice President for VCU Health Sciences, disagrees with UVa’s statement. VCU, one of the largest transplant centers in the country, often works closely with UVa. Levy noted that many donated kidneys go unused due to logistical challenges such as organ transfer delays and overwhelmed surgical teams.
“Sometimes it’s because of organ quality. Sometimes it’s because of geography that prevents the organ from being transferred to the organ center. Sometimes it’s because the surgical teams are too busy to accept another organ,” Levy said during the hearing.
In an interview, Levy emphasized that access to a transplant center is key, as quality of life improves significantly post-transplant compared to being on dialysis. He explained how a transplant center in Roanoke would help increase organ utilization rates by reducing the distance organs must travel and alleviate strain on existing transplant centers.
“In 30 plus years of surgery, I’ve learned that it’s all about the patients,” Levy said, stressing the importance of better serving patients across the region. “Kidney transplantation is not just about survival—it’s about quality of life.”
Carillion’s Plan
The transplant program in Roanoke is led by Dr. Arnold Salzburg, Carillion transplant and general surgeon. Carilion has performed well in organ procurement, securing more deceased kidney donors over the past three years than any other Virginia health system. However, without a local transplant center, these organs are sent to other hospitals for transplantation.
“As many as 5,000 people in our region are experiencing advanced stages of kidney disease—more than any other region in Virginia—and around 2,300 people in the state are on the transplant list, often staying on the list for two or more years before they can schedule a transplant,” Salzburg said in an article published by Carilion Clinic.
For many in Southwest Virginia, access to a kidney transplant program isn’t just about convenience. Patients requiring transplants must undergo frequent medical evaluations before and after the procedure. For those living in Roanoke and surrounding areas, traveling to Charlottesville or Wake Forest adds a layer of difficulty and financial strain.
“We have the infrastructure, we have the ability, now we just need the approval,” Salzburg said during the hearing.
The Virginia Department of Health is set to close the public record on Feb. 28. The state health commissioner will review the case before issuing a final decision in the spring of 2025.
Beyond the immediate decision, debate over Carilion’s proposal has sparked broader discussions about healthcare access in rural regions. Advocates argue that the regulatory process should prioritize patient needs, while opponents warn against creating programs without established records of success. If Carilion’s plan is approved and successful, it has potential to encourage other health systems to pursue transplant programs in areas currently lacking access.
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