A major hospital in Pennsylvania closed its liver transplant program last week, becoming the second medical center this month to take such an unusual step.
The hospital, Penn State’s Milton S. Hershey Medical Center, said Monday that it had closed the program and submitted it for review by federal officials. “The decision to cease operations was made after identifying procedural and clinical documentation concerns,” the hospital said in a statement.
It’s unclear what specific issues led to the closure. But in interviews with The New York Times, six current and former employees said that employees raised a number of concerns about the program, including that it frequently denied content. organ availability, potentially leaving people on waiting lists without life-saving transplants. Hospital officials would not comment on those allegations.
The Hershey closure comes just weeks after Memorial Hermann-Texas Medical Center in Houston suspended its liver and kidney transplant programs. That hospital told The Times that they believed one of their doctors had manipulated records to make some of his own patients ineligible for new livers.
The constant closings are a shock to an implanted system in which programs rarely go offline due to performance issues. According to the American Network for Organ Sharing, the federal contractor that oversees the country’s transplant system and is investigating problems at Hershey Medical Center, there are 142 active liver transplant programs in the United States.
“It happened as quickly as two years,” said Dr. Seth Karp, a transplant surgeon at Vanderbilt University and a former member of the transplant system’s committee that reviews potential misconduct. times is very unusual.”
Hershey Medical Center has previously come under federal scrutiny for safety issues. In 2022, it stop performing the transplant completely after inspectors discovered problems, including a series of cases of transplant recipients experiencing medical problems that required additional surgery.
About a year ago, the hospital rented notice Dr. Johnny Hong, chief of transplant surgery at the Medical College of Wisconsin, restarted the abdominal transplant program. But the hospital performed only seven liver transplants and no kidney transplants last year, according to data released by the American Network for Organ Sharing.
During that time, 21 patients at the hospital waiting for a liver or kidney transplant were taken off the waiting list because they died or were too sick to receive a transplant – a high number compared to the number of transplants performed.
Current and former employees, who all requested anonymity because of fears of retaliation, said the transplant program regularly rejected available livers for patients. In some cases, the program has set its criteria for organ acceptance so strictly that it completely eliminates the chance of a suitable organ, staff said.
In the transplant system, when donor livers become available, an algorithm generates a list of patients who need it most, and officials present that list to those patients’ doctors. It’s no wonder some doctors say no. There are good reasons to do so, such as if the doctor believes the liver will not be suitable for their patient because it is too old or too young, too big or too small, or too sick.
However, hospitals do Have trouble for saying no too often. Federal officials have acknowledged that because transplant centers are evaluated largely on whether their patients survive at least a year after a transplant, there may be an incentive for The center is overly cautious in choosing which organs to accept or which patients to accept.
When doctors refuse to provide organs, they do not need to notify the patient.
At Hershey Medical Center, some employees have raised concerns about the transplant program for at least several months, according to hospital records and current and former employees. Under scrutiny from the American Network for Organ Sharing, the hospital decided to suspend its liver transplant program last week, staff said.
On Monday, Hershey Medical Center said it sent information about the closure to 63 patients who are on the liver transplant waiting list or being evaluated to be on the list and that they are transferring patients to other facilities. other hospital.
The hospital said the closure does not affect its kidney, heart, stem cell and bone marrow transplant programs.
In Texas, Memorial Hermann has said that one of its doctors admitted to altering a patient’s records in a way that made them ineligible for transplant. The Times identified the doctor as J. Steve Bynon Jr., a famous surgeon. It is unclear why Dr. Bynon made these changes.
Dr. Bynon, who works for the University of Texas Health Science Center in Houston and has been on contract to direct Memorial Hermann’s abdominal transplant program since 2011, has not commented on the allegations. UTHealth Houston defended him as “an exceptionally talented and thoughtful physician and a pioneer in the field of intra-abdominal organ transplantation.”
Since the issues were announced on April 11, Some patients’ families have sued or said they plan to sue Dr. Bynon and the hospital. On Monday, the hospital said the investigation was ongoing. Dr. Bynon did not respond to a request for comment.
Susan C. Beachy contributing research.
