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UPMC will resume live-donor liver and kidney transplants

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Friday, July 15, 2011
 

UPMC reopened its live-donor liver and kidney transplants on Thursday, more than two months after acknowledging its surgeons transplanted a kidney from a donor infected with hepatitis C.

Federal reviewers with United Network for Organ Sharing concluded human error was responsible for the oversight, said Dr. Abhi Humar, chief of transplantation at UPMC's Thomas E. Starzl Transplantation Institute.

"I think ultimately we accept responsibility as a team. It was an error of the team," Humar told the Tribune-Review.

The live-donor kidney transplant program at Children's Hospital, which was shuttered temporarily by the suspension of the UPMC programs because it relies mostly on adult donors, also will restart immediately, he said.

The reactivation of the UPMC programs caps a tumultuous period at one of the country's best-known transplant programs. The incident prompted some patients to seek treatment elsewhere and put officials on the defensive about the quality of the programs operated at UPMC Montefiore.

"It's obviously something that we would not have liked to happen," Humar said. "It's been a stressful time for all of us, including most especially for our patients. "

UPMC voluntarily suspended the programs on May 9 without explanation. The Trib first reported the program's suspension and later that it was the result of a hepatitis C-infected liver donor whom officials had missed.

UPMC officials have not identified the kidney recipient.

"He is doing fine, and we continue to monitor him closely," said hospital spokeswoman Jennifer Yates.

A nurse who was suspended and a surgeon who was demoted are now working, Yates said. The surgeon remains demoted, she said.

The two overlooked a chart that contained information about the donor's infection. UPMC's transplant screening process includes blood tests to check donors for infectious diseases such as HIV and hepatitis.

UPMC officials have not received a final report from the UNOS membership and professional standards committee, which met yesterday in Chicago and gave UPMC clearance to restart the programs. UNOS officials, who reviewed the UPMC program in May, likely could conduct additional, unscheduled reviews of the program, Humar said.

The state Health Department will continue to monitor UPMC through its normal procedures after the health system submits a corrective action plan.

The plan includes establishing additional checks and balances so that multiple, independent workers will review donor records, Humar said.

"We now have multiple folds of redundancy built into the system to pick up these issues and problems," he said. "If it gets missed by one person, then there's someone else to be there -- sort of as a safety net."

At least eight patients waiting for transplants at UPMC chose to get listed at rival Allegheny General Hospital in the North Side in the wake of the UPMC developments, Allegheny General officials said.

UPMC should be able to overcome any damage the incident may have inflicted on the program's reputation, said Dr. John Fung, chairman of surgery at the Cleveland Clinic and UPMC's chair of transplantation until 2004.

"It's more important what you're going to do in the future," Fung said. "They're going to need to assess and reassess all the time if there are points in the process that can be improved."

Humar said the programs' primary goals remain patient safety and delivery of quality care.

"I'm very confident that the alterations and changes that we've made will only make the evaluation process and the whole transplant process that much better and stronger," he said.

UPMC surgeons in 2010 performed 62 living-donor kidney transplants out of a total of 152 kidney transplants, according to UNOS data. Yates could not immediately say if UPMC will be on pace to perform the same number of transplants this year. Officials might have a better sense of that once the program restarts, she said.

 

 

 
 


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