Heart donor shortage dooms transplant program

September 5, 2009
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Even though the Michigan Department of Community Health cancelled William Beaumont Hospitals’ permission to run a heart transplant program last fall, no one put two and two together — make that one and two together.

Last October, local leaders — including U.S. Rep. Peter Hoekstra, R-Holland, Michigan State University College of Human Medicine Dean Marsha Rappley and Steelcase Inc. President & CEO James Hackett — sent letters to the MDCH’s Certificate of Need Commission in support of Spectrum Health’s bid to boost the number of heart transplant programs in the state from three to four.

Last November, the MDCH cancelled approval for Beaumont’s heart transplant program at its Royal Oak facility, department spokesman James McCurtis said.

The program had been inactive for several years, the victim of low volume, Beaumont spokesman Bob Ortlieb said.

Ortlieb said about 30 heart transplants occurred at Beaumont from 1989 to 1999 — no more than about four per year. Surgeons would have preferred doing 12 to 15 operations annually, but the number of donor hearts was too low, especially with transplant programs at DMC and U-M serving the same population, he said.

However, Spectrum Health executives said they believe they can serve enough patients to maintain a viable program in Grand Rapids.

“We’ve done studies that show many of our patients are going out of state,” said John Mosley, senior vice president at Spectrum. “We would actually have more patients in the state of Michigan rather than from the other programs.”

From CON staff to Spectrum Health to members of a committee appointed earlier this year to study heart transplants, everyone counted three programs: the University of Michigan Health System, which handles both adult and pediatric heart transplants; Henry Ford Hospital, which performs adult procedures; and Children’s Hospital of Michigan, another pediatric program.

But that turned out to be wrong.

“There’s always been a cap of three CONs for heart and lung transplants,” McCurtis said. “But back in 1996, they made an exception for Henry Ford and Children’s Hospital to share a CON for heart transplants. Henry Ford already had it. … The standards said if (Children’s Hospital) came aboard with an existing facility that does heart and lung transplants, that would count as one CON for the two hospitals.”

Henry Ford Hospital performed the first heart transplant in Michigan in 1985. Children’s Hospital is part of the Detroit Medical Center.

“Never mind,” said James Ball, chairman of the Standards Advisory Committee that has been reviewing the number of programs in Michigan for heart transplants, quoting late comedian Gilda Radner’s hard-of-hearing character Emily Litella from “Saturday Night Live.”

“Our committee has been charged by the commission to report back to them on certain issues and we have an obligation to complete that charge and make a report back,” added Ball, a retired health benefits executive for GM who represented the Michigan Manufacturers Association on the standards committee.

“We do have to conclude our business.”

He said some technical changes to standards may be on tap, and the committee hasn’t yet spent much time discussing liver transplants.

He said he expects to make a preliminary report to the CON Commission this week and a final report by the end of the year.

“Whether all those people would have done all that, had they known: ‘Oh, gee, if we did our homework, we would have known one was available,’” Ball said. “It does serve a useful purpose because every standard has to be reviewed once every three years.”

Butterworth Hospital, a precursor to Spectrum Health, also had CON approval for a heart transplant program in the 1990s, said Bob Meeker, the health system’s strategic program manager. He said the approval lapsed because the hospital was unable to launch the program within 12 months.

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