A major Pennsylvania hospital shut down its liver transplant program last week, becoming the second medical center this month to take such an unusual step.
The hospital, the Penn State Health Milton S. Hershey Medical Center, said Monday that it had closed the program and submitted to a review from federal officials. “The decision to inactivate comes after concerns about clinical processes and documentation were identified,” the hospital said in a statement.
Six current and former employees said that before the closure, staffers had raised concerns about the program, including that it regularly declined available organs, potentially keeping people on the waiting list from receiving lifesaving transplants. Hospital officials would not comment about those accusations.
The Hershey closure comes just weeks after Memorial Hermann-Texas Medical Center in Houston suspended its liver and kidney transplant programs. That hospital told The New York Times that it believed that one of its doctors had manipulated records to make some of his own patients ineligible to receive new livers.
The back-to-back closures are a shock to a transplant system in which programs rarely go offline because of performance problems. There are 142 active liver transplant programs in the United States, according to the United Network for Organ Sharing, the federal contractor that oversees the country’s transplant system and is investigating the problems at Hershey Medical Center.
“To have it happen twice very quickly is very unusual,” said Dr. Seth Karp, who is a transplant surgeon at Vanderbilt University and a former member of the transplant system’s committee that looks into potential wrongdoing.
Hershey Medical Center had been under federal monitoring over safety issues in the past. In 2022, it stopped performing transplants entirely after inspectors found problems, including with a series of transplant recipients who experienced medical problems that required additional surgery.
About a year ago, the hospital announced it had hired Dr. Johnny Hong, who was chief of the division of transplant surgery at the Medical College of Wisconsin, to restart its abdominal transplant program. But the hospital did just seven liver transplants and no kidney transplants last year, according to data published by the United Network for Organ Sharing.
During that time, 21 patients at the hospital awaiting a liver or kidney were taken off the waiting list because they either died or became too sick to receive a transplant — a high number relative to the number of transplants performed.
The current and former employees, who all requested anonymity out of concern for professional retaliation, said the transplant program had routinely declined livers that had become available for patients. In some cases, the employees said, the program had set criteria for acceptable organs so narrowly that it effectively eliminated the chance of a match. It is unclear why the program’s leadership may have done that.
In the transplant system, when a donated liver becomes available, an algorithm creates a list of patients who need it the most, and officials go down the list offering it to the doctors of those patients. It is not uncommon for some doctors to say no. There are legitimate reasons for doing so, such as if the doctor believes the liver would not be a good fit for their patient because it is too old or young, too big or small or too sick.
Hospitals have, however, gotten in trouble for saying no too often. Federal officials have acknowledged that because transplant centers are judged largely on whether their patients live at least a year after a transplant, there may be an incentive for centers to be overly cautious in choosing which organs to accept or which patients to approve.
When doctors decline organ offers, they do not have to notify patients.
At Hershey Medical Center, some staff members had been raising concerns about the transplant program for at least several months, according to the current and former employees and hospital records.
Facing scrutiny from the United Network for Organ Sharing, the hospital chose to suspend its liver transplant program last week, the employees said.
On Monday, Hershey Medical Center said it had sent information about the closure to 63 patients who were either on its liver transplant waiting list or undergoing evaluation to get on the list, and that it was transferring patients to other hospitals.
The hospital said the closure had not affected its kidney, heart and stem cell and bone marrow transplant programs.
In Texas, Memorial Hermann has said that one of its doctors admitted to changing patients’ records in a way that effectively made them unable to get a transplant. The Times identified the doctor as J. Steve Bynon Jr., a celebrated surgeon. It was unclear why Dr. Bynon might have made the changes.
Dr. Bynon, who is employed by the University of Texas Health Science Center at Houston and has had a contract to lead Memorial Hermann’s abdominal transplant program since 2011, has not commented on the allegations. UTHealth Houston has defended him as “an exceptionally talented and caring physician, and a pioneer in abdominal organ transplantation.”
Since the issues there became public on April 11, some patients’ families have sued or indicated that they plan to sue Dr. Bynon and the hospital. On Monday, the hospital said its investigation was ongoing. Dr. Bynon did not respond to a request for comment.
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