Number of Deaths More Than Expected at St. Vincent Kidney Transplant Program
St. Vincent Medical Center had a "higher-than-expected" mortality rate between January 2002 and June 2004 among patients in its kidney transplant program, prompting two insurers to stop sending kidney transplant patients to the hospital, the Los Angeles Times reports.
According to the Times, 36 patients died within one year of surgery during that two-year period -- 15 more than is expected. The rate of patient survival at least one year after surgery at St. Vincent's was 92.8% between January 2002 and June 2004, compared with 95.9% nationally, according to the Scientific Registry of Transplant Recipients.
In addition, statistics from the Scientific Registry indicate that 86% of transplanted kidneys during that time functioned for at least one year, compared with the expected rate of 91%.
The Scientific Registry data also indicate that in 2004, 25% of the kidneys accepted for transplant at St. Vincent were of marginal quality and had been refused by other transplant programs. Nationally, the rate of acceptance for poorer-quality kidneys is 15%.
The results have caused Aetna and Humana to stop sending kidney transplant patients to the hospital, and the United Network for Organ Sharing last month launched an investigation of the hospital's transplant program.
Transplant Administrator Deborah Maurer and Co-Medical Director Robert Mendez last week said the hospital has higher rates of death and kidney failure because the program deliberately has treated sicker and older patients. More non-English speakers and less-educated patients also received transplants at the hospital, and those patients may have had difficulty following physicians' orders.
Hospital officials said that in recent months, doctors have been more selective in choosing transplant patients and accepting organs. Officials said the hospital also has improved care for patients after they receive transplants.
In addition, program staff will tell transplant patients of the lower-than-expected survival rates for the kidney program.
The hospital expects to perform 165 kidney transplants this year, 51 fewer than in 2004 (Ornstein et al., Los Angeles Times, 12/17).