Patients on transplant waitlists face uncertainty after hospital suspends program

**Embargo: Denver, CO** Porter Adventist Hospital is halting its transplant surgeries for up to a year while it updates the program.

(CNN) — A Denver hospital announced Tuesday it is halting its transplant program temporarily, which will leave 232 patients ineligible for an organ transplant if a match pops up during that time — unless they transfer to a new program.

A spokeswoman for Porter Adventist Hospital, Wendy Forbes, told CNN that time is of the essence and that patients are being advised to contact either of two other transplant programs in the area now to ensure that if a suitable organ becomes available, they are able to get the transplant.

The voluntary suspension of the hospital’s kidney, liver and pancreas transplants is expected to last six to 12 months, the hospital said in a statement. Experts say that wait times for these organs can last years and that a months-long closure could be especially pressing for patients near the top of the lists.

“We’re short-staffed,” Forbes told CNN, adding that “we need to fill some vacancies on the team” that have accumulated over the past couple of years.

During the closure, the hospital plans to “recruit and expand clinical support teams and evaluate processes, technology and operational needs,” according to the hospital’s statement.

Todd Folkenberg, CEO of Porter Adventist Hospital, said in the statement, “The decision to temporarily stop performing transplants was not taken lightly.”

Uncertainty

“Uncertainty is a big problem for patients in general, certainly that are waiting for organ transplants,” said Dr. Niraj Desai, director of the Kidney and Pancreas Transplant Program at Johns Hopkins Hospital and an assistant professor of surgery at the Johns Hopkins University School of Medicine.

Desai, who’s not involved with the Denver hospital, explained that the process of getting a new organ has improved greatly over the years to the point that “many, many people are eligible for organ transplants — far more than we have donors.”

“Our biggest issue in transplantation is the long lists we have,” said Desai. “Unfortunately, many patients do not ever come to a transplant. They get too sick or they pass away before an organ becomes available for them.”

An average of 20 people die every day waiting for a transplant, according to the United Network for Organ Sharing, which manages the nation’s transplant system. The demand for transplantation has also grown in recent years, with the number of transplants that have been performed rising 20% nationwide between 2012 and 2016, the organization says.

Roger Brown, director of the organization’s Organ Center, said that these types of closures happen “a few times a year,” where centers “inactivate” for more than two weeks and patients move to new programs.

“I wouldn’t call it an aberration, but I wouldn’t call it common either,” Brown said.

“Those candidates on that waiting list then, while that program is inactive, are not eligible to receive any organ offers … but those patients continue to accrue waiting time,” he said. “They do not lose their place in line.”

A kidney patient’s place in line generally depends heavily on how long they’ve been waiting, while a liver patient’s tends to depend more heavily on how sick they are, Brown added.

“The patients at the top of the list are the ones that it’s most critical to get their care transferred to another center,” Desai said. “They’re the folks who are going to miss out on organ offers.”

Given that the typical kidney transplant patient might wait three to seven years, some patients might not be critically affected by a temporary closure, he said.

The hospital’s statement notes it is working with the United Network for Organ Sharing, which Brown said has policies in place for events like these. But placing patients in new programs also requires that nearby hospitals have the resources to take on a sudden increase in patients.

Dr. Elizabeth Pomfret, chief of UCHealth University of Colorado Hospital Transplant Center, said in a statement to CNN that they are prepared for the possible influx of new patients.

“Because of a dramatic increase in transplant volume over the past two years, we have recently hired additional surgeons, hepatologists, nephrologists and nurse coordinators, and we are able to care for these patients and ensure seamless care,” said Pomfret, also a professor of surgery at University of Colorado School of Medicine.

‘Critical mass’

“Just for conjecture’s sake: If you were to even do one transplant, you still would need 24/7 coverage,” Desai said.

Speaking in general terms, he explained, scaling back a transplant program temporarily (versus halting it altogether) is not always possible due to the complex, round-the-clock needs of a transplant program. An organ could become available at any time of the day or night, and patients need constant care, especially if they develop complications.

“Scaling back might not always work,” he added. “You almost need a critical mass just to get started.”

In the case of Porter Adventist Hospital, Forbes said, their transplant program is over 30 years old, and this is the first time it has been put on hold.

The hospital is part of Centura Health, which operates 17 hospitals and a variety of other medical facilities across Colorado and western Kansas.

Forbes said that the hospital began reaching out to all 232 patients affected by the program’s voluntary suspension on Tuesday, when the closure was announced, sending them to two other transplant programs in the area: UCHealth and Presbyterian/St.Luke’s Medical Center. All patients with routine appointments and a number of others have already been contacted, Forbes said, and “letters should be reaching mailboxes Saturday.”

The rest of the hospital’s programs will continue uninterrupted, including caring for patients who have already had transplants, according to a statement by its chief medical officer, Dr. Patricia Howell.

In February, the state health department investigated an infection control breach that may have affected orthopedic and spine surgery patients at Porter Adventist Hospital. The hospital closed its operating rooms on April 5 over concerns about “the cleaning process for surgical tools following orthopedic and spine surgeries. The other potential concern was related to residue on surgical tools after sterilization,” according to a statement in April by Dr. Larry Wolk, executive director and chief medical officer of the Colorado Department of Public Health and Environment. The hospital resumed surgeries a week later.

Forbes told CNN this is unrelated to the transplant program’s temporary closure. The hospital’s closure was not a result of any action by the state health department, spokesman Mark Salley confirmed.