Buffalo, NY, USA: ECMC Suspends Living Kidney Transplants

[Clark]

http://www.wkbw.com/video/ECMC-Suspends-Living-Kidney-Transplants-261768271.html

ECMC Suspends Living Kidney Transplants
By John Borsa

ECMC is suspending its living kidney transplant program following the death of a donor from an illegal drug overdose.

Doctors successfully transplanted the organ to a family member in the spring of 2013. Six months later, the donor died.

ECMC decided, with consultation with the United Network for Organ Sharing, the non-profit organization that regulates live organ donations, to temporarily suspend the program until mid-July 2014.

The hospital released the following statement:

“ECMC proactively decided to temporarily suspend living donor recoveries. The ECMC transplant program otherwise continues unaffected and ECMC fully expects that the living donor program will be reinstated by mid-July 2014. In the meantime, the transplant program will fully support and guide any potential living organ donor and recipient in the alternatives available to them.”

[Clark]

http://livingdonorsarepeopletoo.com/living-donor-dies-at-erie-county-medical-center/

Living Donor Dies at Erie County Medical Center
by LDPeopleToo

Here are the facts:

ECMC is suspending its living kidney transplant program following the death of a donor from an illegal drug overdose.
Doctors successfully transplanted the organ to a family member in the spring of 2013. Six months later, the donor died.
ECMC decided, with consultation with the United Network for Organ Sharing, the non-profit organization that regulates live organ donations, to temporarily suspend the program until mid-July 2014.
The hospital released the following statement:
“ECMC proactively decided to temporarily suspend living donor recoveries. The ECMC transplant program otherwise continues unaffected and ECMC fully expects that the living donor program will be reinstated by mid-July 2014. In the meantime, the transplant program will fully support and guide any potential living organ donor and recipient in the alternatives available to them.”
 
If that were the end of it, this would be a short post. But it’s not. At least two news stations, WIVB and WGRZ, managed to make this tragedy all about the recipients. Here is the missive I sent to both these reporters (the version below went to Brown at WGRZ; I altered the wording regarding Laurie and Chase for Ms. Kingston):
 
As a living kidney donor and living donor activist, I read the news of ECMC’s living donor death with great sadness. My sorrow, however, became dismay when I realized your story’s only concern was the temporary cessation of transplants. As if the donor’s death were nothing more than an afterthought.
The first living kidney donor transplant occurred in 1954, yet a psycho-social evaluation was not required for potential living donors until 2007 (CMS Final Rule). But it wasn’t until last year, under pressure from HRSA at DHHS, that the policy specified details.
Currently, a transplant center must obtain the prospective living donor’s history of “smoking, alcohol, and drug use, abuse, and dependency”.
They must also screen for “any psychosocial issues, including mental health issues that might complicate the living donor’s recovery and could be identified as potential risks for poor psychosocial outcome”.
And finally, a transplant center is supposed to exclude or reject any potential living donor with a “diagnosable psychiatric condition requiring treatment before donation, including any evidence of suicidality”.
But here’s the reality:
Approximately, 30% of U.S. living donors experience depression, anxiety, anger, grief and/or PTSD post-donation.
One-third of living kidney donors’ psychological and distress scores worsened one and three months following donation. (Taghavi 2001).
15% of kidney donors are on antidepressants three months after donation (McCune)
2% of donors had a Diagnostic and Statistical Manual of Mental Disorders IV (DSM-IV) psychiatric diagnosis preoperatively, however, 15% had an Axis I disorder at 12 months. (Smith et. al. 2004).
All of these findings well exceed the community sample range of 2 to 9% for major depression as reported in the DSM-IV.
Transplant centers are not specifically required to offer structured aftercare or support services to living donors, and in fact, not a single center does. Yet it’s been determined by multiple studies that a lack of support contributes to these issues, and early counseling may alleviate suffering.
ECMC determined this living donor to be healthy, both physically *and* psychologically. Yet six months later, s/he is dead. This is a patient safety failure of massive proportions. Instead of lamenting the delay, Laurie and Chase should be grateful; this investigation just might save her life.
Because after all, we’re more than medical supply. Living donors are people too.
 
Note: In 2007, OPTN’s Living Donor Committee proposed comprehensive standards for living donor evaluation, selection and treatment. These policies were violently rejected by the “membership” (aka the transplant centers). I bring it up because the proposed policy contained an appendix with a detailed rationale for interviewing a “Donor Support Person” (spouse, significant other, parent, friend, etc) during the living donor evaluation AND an inventory of questions for a POST-donation psychosocial interview of the living donor.

[Clark]

http://www.wgrz.com/story/news/health/2014/06/03/ecmc-kidney-transplant-suspension-living-donors/9923033/

ECMC Suspends Kidney Transplants By Living Donors
Scott Brown

...

Laurie was going through testing to donate one of her kidneys to Chance, when they found out last week that ECMC is putting all kidney transplants from living donors on hold.

...

Laurie found out about the suspension of the program first and then broke the news to Chance.

Chance Mitchell: "When I got the phone call it took the wind right out of me, took the wind right out of me honest, but she [Laurie] was a ray of hope and sunshine and through her tears she encouraged me and I tried to be strong for her at the same time."

Laurie Perry: "I was a little upset, kind of like I don't want to say anger but it makes you wonder, it puts different questions in your head but I try to be positive and I try to look for the positive for everything and I think something positive will come out of the next six weeks. And that's how I feel when it comes to you (Chance) having to wait, and it's for you to get stronger."

Scott Brown: "They say by mid-July the program should be back up and running, are you confident about that?"

Chance Mitchell: "Yes I am confident, I'm confident that these guys [at ECMC] will do what they need to do to get the program up and running again."

Laurie Perry: "I told Chance it's (the suspension) for him to get stronger and better before it's our turn (for a transplant), so it's just a little hiccup in our path, you know for our journey."

Again, the suspension is for transplants from living donors, transplants from deceased donors are continuing as usual.

[Clark]

http://wivb.com/2014/06/03/ecmc-temporarily-suspends-living-organ-donor-transplants/

ECMC temporarily suspends living organ donor transplants
By Rachel Kingston

...

ECMC said it has directly notified all potential living organ donors and potential recipients of the decision.

It is a crucial situation, because ECMC’s Center of Excellence is now the only program in the area that offers organ transplants from living donors.

Patti Merritt told News 4 the first thing that goes through a patient’s mind, upon hearing news such as this, is “Fear. People are afraid, and it’s very upsetting to know that the wait will be longer.”

Merritt would know. Her life was saved by a living organ donor 13 years ago, when her sister-in-law gave her a new kidney.

Merritt has since co-founded the Kidney Connection – an online forum where people in need of transplants can post their profiles, and find donors.

She wants dialysis patients and those on kidney waiting lists to know, this temporary setback does not mean they should stop searching for living donors.

“Any kidney donation is the best treatment for kidney disease, absolutely. A kidney from a living donor, if you have a choice, is preferred,” Merritt said. “You’re able to plan ahead. You can receive a kidney from someone who has been screened, and determined to be very healthy. You’re able to plan a surgery, as opposed to waiting on the list and getting a call spontaneously. All kidneys that are transplanted tend to last a very long time, but living kidney donors’ tend to last even longer.”

The most important step for anyone in need of a kidney or other living organ transplant, Merritt said, is to be proactive. She advises people against simply getting their names on a list, and waiting, hoping for the best.

“When people hear about your need, they can be inspired. The Kidney Connection has had many successes, and strangers have come forward and given kidneys, and saved lives,” she said. “We’re very hopeful, and confident, that the program will be restarted soon.”

In the meantime, patients can still come to ECMC for checkups and treatment, such as dialysis. Transplants from non-living donors continue unaffected.

[Clark]

http://www.bizjournals.com/buffalo/news/2014/06/09/ecmc-organtransplant-suspension-voluntary.html?page=all

ECMC organ transplant suspension voluntary
Tracey Drury

Organ transplants by living donors are expected to resume in mid-July at Erie County Medical Center, following a voluntary suspension by the hospital.
ECMC last month opted to temporarily suspend transplants while a review is completed by the United Network for Organ Sharing (UNOS), a national nonprofit organization that operates the nation’s organ procurement and transplantation network under contract with the federal government.
The review followed the death last fall of an individual from an unrelated overdose of illegal drugs who had donated an organ in spring 2013. UNOS learned of the death last fall, since it requires notification on all donor deaths, regardless of the cause, but the agency did not come to Buffalo to do their review until May.
A report has not yet been issued back to ECMC, but officials expect a positive outcome, said Tom Quatroche, vice president of marketing, planning and business development.
“We decided to suspend the program until we meet with them,” he said. “They didn’t shut it down. They haven’t finished the review yet, but we felt let’s suspend it, so that if there is an issue, we didn’t put anyone at risk.”
UNOS in 2006 began a patient safety system for transplant centers to report medical problems experienced by living donors for two years after donation surgery. Major adverse events are rare, though centers must report any living donor death; loss of a function in a donor’s remaining kidney or other organ of which a portion was donated; or any organ that could not be transplanted or is not used for the original planned recipient.
ECMC last year received high marks during a routine review of the program by UNOS. The hospital operates the Regional Center of Excellence for Transplantation & Kidney Care, a joint program with Kaleida Health. The suspension affects only the living donor program, with transplants of organs from non-living donors continuing, as well as checkups and other services at the site.
The living donor program accounts for a smaller fraction of surgical procedures at the Grider Street site. Nationally, living donors account for about 6,000 transplants each year. The national organ transplantation list includes more than 118,000 people.
Those who participate in the living donor program must be at least 18 years old and first pass a series of physical and mental health screenings, including a full psychological review. UNOS stresses in its materials for potential donors and recipients that there has been little national systematic long-term data collection on long-term risks.
However, in its guide for living donation, UNOS does warn of the possibility of negative psychological symptoms during the healing process and even years after the donation, including feelings of regret, resentment or anger. Overall, UNOS says the risks are considered to be low.
At ECMC, four individuals were scheduled to receive transplants in June, surgeries that will be postponed until after the suspension is lifted. Patients also have the option of receiving a transplant from a deceased donor if one is available or transferring to another transplant program.
Since ECMC’s transplant program was established in 1964, more than 600 kidney transplants have been completed, including over 125 living-donor transplants. The program expanded in 2004 to include pancreas transplants. According to the hospital, over the past four years, about half of all patients on the waiting list received a transplant within one year.
Quatroche was also confident the suspension won’t hurt the program’s reputation, pointing instead to a series of positive internal and external accreditations and reviews that demonstrate the quality of the program.
“We’re taking every precaution to make sure that we let the process continue,” he said. “We always look at our processes, and we can always look at what could be better.”

[Clark]

http://wivb.com/2014/09/05/ecmc-to-reumse-living-donor-transplants/

ECMC to resume living donor transplants

The living organ donor transplant program at Erie County Medical Center, which was suspended following the death of a donor, has now resumed.

In the spring of 2013, a living donor successfully provided a transplant organ to a family member. About six months later, that donor died from an illegal drug overdose. After conferring with the United Network for Organ Sharing, ECMC voluntarily decided to suspend the living transplant program, while it reviewed its policies.

The hospital says the United Network for Organ Sharing, the non-profit organization that regulates live organ donation in the United States, will continue to monitor the program.

“We’re pleased that the program review is complete and we are cleared to resume the ECMC transplant program. This was a blip in an otherwise smoothly operated program at our transplant center, of which we are justifiably proud. Our families and patients can have every confidence in our outcomes and high level of service,” said Richard C. Cleland, president/chief operating officer and interim chief executive officer, ECMC Corp.

While the matter was investigated, patients were still visiting ECMC for checkups and treatment, such as dialysis. Transplants from non-living donors continued unaffected.