Legacy plan would surely harm OHSU
A competing kidney transplant program would hurt the financial stability of the highly successful state team at University Hospital
Monday February 22, 1999
By John Dellenback
My interest in kidney transplants began with the failure of my own kidneys in late 1996. After some serious difficulties and time in dialysis, I received a kidney transplant in May 1997 at Oregon Health Sciences University Hospital. From their careful briefing, through surgery, hospital care and regular follow-ups, right up to the present, the work of the OHSU team members has been outstanding. I am back playing tennis and my health is great.
Kidney transplantation is one of medicine's great success stories. Here in Oregon, patient survival rates at one year are nearly 100 percent. Many kidney transplant patients lead active lives for many years after a successful transplant. For nearly four decades, OHSU specialists have transplanted kidneys, saved many lives and significantly reduced the inconvenience and cost of dialysis.
Legacy Health System now intends to set up another kidney transplant program in Portland. This may be profitable for Legacy, but it may work against efficient and high-quality health care for Oregonians.
Since the first Oregon kidney transplant in 1959, the OHSU team has transplanted nearly 2,700 kidneys. OHSU's team of transplant physicians, surgeons, nurses and laboratory technicians offers decades of experience. As Oregon's only academic medical center, OHSU has combined exceptional care for kidney transplant patients while educating the next generation of professionals and conducting nationally respected clinical transplant research.
Like the rest of the nation, Oregon has a shortage of transplantable organs. I was fortunate to receive the gift of a kidney from my wife, Mary Jane, but as of September 1998, 176 patients were waiting for a kidney from a deceased donor.
A second transplant program will not help where help is most needed: in increasing the number of donated organs. Proposed changes in the way organs are allocated could make the supply of kidneys in the Pacific Northwest even tighter.
National research shows that graft survival rates (the successful functioning of a transplanted kidney) are highest for the most experienced teams. Inexperience could result in failed or rejected organs in the months after transplantation. Those patients end up back on the waiting list, worsening the already critical shortage.
OHSU has the experience to make sure donated kidneys are not needlessly lost. The highly reputed chief transplant surgeon Dr. John Barry has been involved in kidney transplantation at OHSU since 1969. Dr. Douglas Norman, chief of transplantation medicine, has been at OHSU since 1979 and has more than 20 years of experience in the field. In 1997 alone, OHSU performed 145 kidney transplants, putting it among the top 20 centers nationwide in terms of volume.
OHSU's team has a depth of personnel that has demonstrated its capacity to provide excellent service 24 hours a days, seven days a weeks. Who would be the backup for a new program's physician and surgeon? Clearly, they will not be able to work constantly. What will happen to patient care when first-line staff are not on service?
In addition, a second regional kidney transplant program would threaten OHSU's mission to offer the highest level of care to low-income Oregonians. The volume of kidney transplants currently performed on insured patients helps OHSU absorb the cost of transplantation for patients who have no insurance and no resources. A competing program could leave OHSU treating most of the uninsured patients along with patients having the most complicated and costly medical problems, thus threatening the financial stability of the university's entire program.
Kidney transplantation is not an ordinary or high-volume patient service, and OHSU is at the top of its field in this specialty. There is no evidence that a second program would improve the outcomes for Oregonians who need this life-saving procedure. On the contrary, overall treatment might well be hurt.
I earnestly hope that Legacy will not confuse what is best for Oregonians who have kidney disease with what Legacy feels is best for its own financial welfare. Let us put the focus where it is most needed. I urge all Oregonians to understand the life-saving gifts they are able to give by becoming organ donors.
John Dellenback of Medford is a four-time Oregon congressman and former director of the Peace Corps. At the time of his kidney transplant in 1997, he was 78 -- the oldest recipient of a kidney at University Hospital.
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