Liver Transplant Center’s Survival Rate Too Low

Between January 2003 and June 2005, twice as many patients as expected died within a year of undergoing liver transplants at the University of Southern California University Hospital in Los Angeles, according to data released by the Scientific Registry of Transplant Recipients, the Los Angeles Times reports. Thirty-eight patients died within the time period.

A review by the Times found that the USC liver transplant program's one-year survival rate has been declining since at least 2002. According to the most recent data, the program has a one-year survival rate of 75.8%, compared with the national average of 86.6%, making it the fifth-lowest rate in the country.

The survival rate also is below federal and state standards to receive certification and funding for the program: Medicare requires a survival rate of 77%, and Medi-Cal requires a survival rate of 80%.

The hospital performed 92 transplants last year, about three times as many as the now-shuttered programs at St. Vincent and the University of California-Irvine medical centers recently performed cumulatively.

The Department of Health Services on Wednesday said it will begin investigating the center. In addition, CMS is conducting a broad review of all federally funded centers.

Rick Selby, director of USC's liver program, defended the program and said the survival rates could be low because the hospital routinely performs only liver transplants on patients waiting for combined liver-kidney transplants. According to Selby, most patients' kidneys recover after a liver transplant so the hospital avoids the combined surgery.

Selby said other transplant centers' survival rates likely would be lower if the patients who had combined transplants were included with the liver-only data.

However, a review by the Times found that "Selby's premise appears to be inaccurate." Scientific Registry data show that in 2003 patients who had the combined liver-kidney transplants had an average survival rate of 81%.

Selby also said the low rate could be attributed to a large number of extremely ill patients who receive transplants at the hospital (Ornstein/Weber, Los Angeles Times, 7/13).