First heart transplant makes mark

December 12, 2010
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The first heart transplant in Grand Rapids shows that Spectrum Health has the technical prowess to manage the complicated procedure, a health care consultant said recently. Now comes the hard part.

“A test of the program is its ability to produce statistics,” said Michael LaPenna, a Grand Rapids-based consultant who works with businesses and health care organizations across the country.

Many of the 43 heart and lung transplant programs approved by the Centers for Medicare and Medicaid began their programs 20 or more years ago and have long-established reputations.

“Can it (Spectrum Health) be comparable to other outstanding programs around the country? Busier programs develop skills and competencies, and teams become very adept at the technology. Can they demonstrate that, time after time, they can deliver a quality product?” LaPenna said.

Rahn Bentley, 50, of Kentwood was the recipient of the first heart transplant performed at Spectrum’s Fred and Lena Meijer Heart Center. Three others are on the waiting list for transplants there, said Dr. Michael Dickinson, medical director of Spectrum’s heart failure program.

The procedure began late on the Saturday after Thanksgiving and concluded early the next day, said transplant surgeon Dr. Asghar Khaghani, who was assisted by Dr. Robert Hooker of West Michigan Cardiothoracic Surgeons.

Plagued with congenital heart defects, Bentley also made history in 1966 when, at the age of 6, he became the youngest person to undergo open heart surgery at Butterworth Hospital. And in 2009, he received one of the first left ventricular assist devices installed at Spectrum.

His twin brother, sportscaster and former Buffalo Bills linebacker Ray Bentley, said Rahn Bentley was laughing and joking the day after the surgery.

At an Alliance for Health public hearing in January, Bentley advocated in favor of Michigan Department of Community Health’s permission for heart transplants at Spectrum.

“It was nice to be in Grand Rapids, where I had all the support of my friends and everything,” Bentley said about the LVAD procedure. “It’s something that really played a role in my getting better, because I had numerous complications.”

Dickinson said Bentley was placed on the Spectrum transplant waiting list in early November, when it was established. The donor of the heart received by Bentley was identified last week as Tim Korzen of Ada Township, who died Nov. 26 after contracting bacterial meningitis but was an organ donor, allowing him to save four lives.

“I can’t tell you how much that means to Rahn,” Ray Bentley added. “That was one of his biggest concerns — that he could go to Chicago to get this done and not have family immediately around. When he got the news that it was going to happen in Grand Rapids, that was a very exciting time and very happy day for the Bentley family. Within a month here we are, and it’s already happened.”

It was just an hour from the time that Bentley, the father of two grown sons, was notified that the donor heart was available until he was on the operating table, Ray Bentley said. Dickinson said Bentley originally planned to have a transplant performed at Northwestern University in Chicago.

That stands in contrast to the experience of Spectrum Health Senior Vice President for Strategy and Business Development John B. Mosley. On St. Valentine’s Day 2006, it took Mosley six hours to get from Grand Rapids to Indianapolis for a liver transplant when his original transportation arrangements fell through.

“That’s the whole essence of having these kinds of programs close to home,” Mosley said. “By being close to home, you also get people who decide they want to have the transplant because of the convenience.”

Khaghani said the next milestone for Spectrum Health will be a lung transplant, which can be done by itself or in conjunction with a heart transplant.

In its Certificate of Need application, Spectrum Health indicated it expected to perform at least nine transplants in the first year and 33 over the first three years. CMS requires a track record of 10 heart transplants before approving reimbursement for a new transplant program.

Spectrum told the MDCH that it expects to lose $3 million during the initial phase. Spectrum Health Hospitals President Matt Van Vranken said Spectrum is picking up Bentley’s tab.

Economic Alliance of Michigan Vice President of Health Policy Dennis McCafferty said hospitals don’t see heart transplants as a money-making service line.

“This I’ve heard from various other hospital folks; it’s a definite money-loser for them for the first several years,” McCafferty said. “You just don’t have volume. There’s an awful lot of front-end capital requirements, you’ve got to hire the right surgeon and support staff, you’ve got to have a facility that’s set up for it. They are certainly not doing it because it’s an income opportunity.”

LaPenna said that the technical expertise required in a heart transplant program may buoy other hospital services.

“They develop skills that can be translated to other patients,” LaPenna said. “You’ve got processes that assure quality at the highest level for a particular challenge, which means then that quality transcends over into other things.”

In addition to Northwestern University, West Michigan heart transplant candidates in the past were referred to the University of Michigan in Ann Arbor, Henry Ford Hospital in Detroit and the Cleveland Clinic, Dickinson said.

“It’s not as revolutionary as it was once,” McCafferty noted.

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