That left 20 people awaiting heart transplants in potentially fatal uncertainty and a gaping hole in Oregon’s health care system. OHSU and Providence have since helped patients travel to Seattle, Spokane and San Francisco for transplants -- a costly and burdensome process.
Providence officials said last year that they had no immediate plans to revive their defunct heart transplant program, but have left the door open since they started to accept OHSU patients. Wednesday, Dr. Dan Oseran, executive medical director of Providence Heart and Vascular Institute, said that is still on the table but the first choice is to partner with OHSU on a jointly operated transplant unit. “We don’t know what the future holds,” Oseran said. “Would we ever do it alone? We might. But we prefer a single collaborative effort.” That effort could be unevenly matched. OHSU was forced to suspend its transplant program in August when all four of its cardiologists quit. One surgeon followed. Since then, OHSU leaders have tried to lure in new advanced heart failure cardiologists but have not been able to secure a recruit.
Cardiologists are especially important to heart transplant programs because the needs of patients are so specific and extreme that not just anyone can take care of them. However, it will take more than one doctor to get it running again, and so far, OHSU officials have not made the first hire. Last fall, it launched an independent peer review to evaluate the program.
Providence says it is already the highest-volume heart care program between San Francisco and Seattle, with 900 to 1,000 surgeries performed each year. It has gotten larger since OHSU’s difficulties, taking on about 350 former OHSU patients.
Providence is trying to fill a hole in the market created by last year’s implosion of the heart transplant program at crosstown rival Oregon Health & Sciences University. OHSU halted its heart transplant program after the exodus of several key cardiologists for reasons Pill Hill officials have never explained.
Providence also has the largest advanced heart failure team in the Oregon and has quietly hired two transplant doctors. The cardiology department has also hired a nurse from OHSU’s advanced heart failure program and several support staff to deal with the influx of patients.
One of the departed OHSU cardiologists, Jill Gelow, joined the Providence program.
Providence officials insist that Oregon needs a resident heart transplant operation. The University of Washington, which has had to absorb Oregon transplant patients, strongly agrees, said Dr. Jacob Abraham, executive director of advanced heart failure.
Volume is key to any transplant program’s success. Abraham said there’s no doubt Oregon generates a sufficient number of transplant candidates -- 30 to 50 a year -- to support a program.
Providence would need approval from both the federal Centers for Medicaid and Medicare and the United Network for Organ Sharing before launching a program. About 2,500 to 3,000 heart transplants are conducted annually in the U.S., far less than the approximately 250,000 people a year who need a new heart. The imbalance is created by the shortage of donor hearts.
OHSU officials say they are determined to get back into the heart transplant business. But the range and size of Providence’s program raises the question of what OHSU would bring to the table in a collaboration or if it is still the best-suited institution to provide that service to Oregonians.
As part of its attempt to restart the transplant program, OHSU has asked for several reviews of its internal culture and practices that led to the heart transplant program’s shutdown. Those reviews includes an evaluation of its relationship with Providence.
In keeping with OHSU’s handling of its entire transplant issue, OHSU officials have said the review’s findings will remain top secret.
Providence heart program hoping to fill void left by OHSU
OREGON UPDATE
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By Jeff Manning | The Oregonian/OregonLive and Molly Harbarger | The Oregonian/OregonLive | February 12, 2019
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