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Allegheny General Hospital liver transplant program certified

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Thursday, Jan. 28, 2010

The two-year-old liver transplant program at Allegheny General Hospital has received a long-awaited Medicare certification, a key approval that allows it to compete head-to-head with rival University of Pittsburgh Medical Center.

The certification from the Centers for Medicare & Medicaid Services solidifies the region's second adult liver transplant program, which is helping AGH retain patients it otherwise would refer to other transplant centers, said Dr. Ngoc Thai, director of the hospital's Center for Abdominal Transplantation and Liver Disease.

"It gives the referring physicians an alternative choice," Thai said.

Surgeons at the program have performed 24 liver transplants since its establishment in November 2007. Thai said the transplants were performed on the sickest patients -- with an average score of 30 on a numerical scale called MELD, which stands for Model for End-Stage Liver Disease.

The scoring system ranks liver transplant candidates on a scale ranging from 6 for the least ill to 40 for those at greater risk of death. A Tribune-Review series published in March 2008 exposed the practice of doing transplants on people with scores of 14 and lower, despite research showing those patients have better odds of living at least a year without transplant surgery. AGH was not among centers doing such surgeries.

AGH officials said its liver transplant program benefits patients whose insurance coverage prevents them from getting the surgery in Pittsburgh and instead would travel to out-of-state transplant centers such as The Cleveland Clinic or Johns Hopkins in Baltimore. Before the program, as many as 30 patients were referred to those centers.

Betty Duddy of Hempfield, who received a liver at AGH on Dec. 5, said her insurer, Gateway Health Plan, covered a transplant only at AGH.

"I can't praise these people enough," said Duddy, 59, who was diagnosed with hepatitis C in 2001. "They are a fantastic team, easy to talk to and explained things so you can really understand what's going on."

The Medicare certification involved a review of the hospital's clinical expertise, patient outcomes and protocols related to donor selection, organ recovery, patient education and selection criteria.

Thai said he expects the hospital to hire surgeons, hepatologists and transplant coordinators. The goal is to perform 40 to 50 liver transplants a year. UPMC, considered among the largest transplant programs in the country, last year performed 92 transplants using organs from deceased donors.

Surgeons at AGH also perform heart, kidney and pancreas transplants.

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