December 29, 1997 in Nation/World

Kidney Transplant Program May Be Reviewed

By The Spokesman-Review

The government has asked for a review of the kidney transplant program at Sacred Heart Medical Center because it performed at less-than-expected survival rates from 1988 through 1994.

But the United Network for Organ Sharing may not actually review the Sacred Heart program. The kidney program has dramatically improved its performance since 1994. Only one of 41 kidney transplants has failed in the last 18 months.

“It’s like it’s history; it’s ancient history,” said Dr. Robert Golden, program director for the kidney transplant program. “We’ve dealt with the problem.”

Last week, the federal Department of Health and Human Services asked the national organ sharing network to review 11 kidney, nine liver and nine heart transplant programs nationally because of performance problems.

That request is based on the just-released report on organ transplant survival rates done by the national organ network. The network runs the nation’s transplant program and evaluates the more than 97,000 transplants done by hundreds of programs nationwide.

The organ network has about three more weeks to report back to the federal Health and Human Services Department on its plans for reviewing the 29 transplant programs.

But the network probably wouldn’t review a transplant program that has improved its survival rate to above-expected levels since 1994, said Joel Newman, a network spokesman.

Network officials cautioned that patients should consider survival rates as only one factor in choosing a transplant center. Officials also said excellent programs may end up on the review list.

For instance, the federal Health and Human Services Department flagged the prestigious kidney program at the University of Alabama Hospital in Birmingham, where about 80 percent of 1,652 kidney transplants succeeded.

At Sacred Heart, about 77 percent of the 180 kidney transplants from 1988 through 1994 succeeded. But the program was expected to have a success rate of about 84 percent.

After losing eight of 24 transplants in 1993, the kidney program started an internal review, Golden said. A study group pored over program results and determined that kidneys were failing between 10 days and six weeks after surgery.

Transplant drugs weren’t being used as effectively as possible, the study group found. Kidney biopsies weren’t being done as often as necessary, Golden said.

So the program started using newer and better drugs. Kidney biopsies were performed more often. The program became more tightly supervised, Golden said.

From 1994 up to the present, about 88 percent of the 129 kidney transplants have succeeded.

“We’ve gone miles and miles, but we’re still not there,” Golden said. “There’s no magic formula to develop the perfect kidney program.”

Kidney transplants are different from other organ transplants, such as hearts and livers. The body’s immune system is much more likely to reject a new kidney than a heart or a liver.

But if a kidney fails, the patient can go on dialysis and eventually could have another transplant.

“With other transplants, if the graft fails, the patient probably dies,” said Liz Pierce, program manager for the kidney transplant program.

, DataTimes

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