A year after the Queen’s Medical Center reopened the only organ transplant hub in the Pacific, the health provider is ramping up efforts to more than triple the number of surgeries to match peak levels eight years ago.
The Queen’s Transplant Center, established in January 2012 after the abrupt closure of Hawaii Medical Center and its transplant facility, has completed a dozen liver and 19 kidney replacements in the past year and is on an aggressive plan to increase the number of procedures in 2013, said Alan Cheung, the center’s medical director.
The former Transplant Institute of the Pacific was shuttered when Hawaii Medical Center’s Liliha campus went out of business in December 2011, canceling scheduled surgeries and forcing numerous transplant hopefuls to fly to the mainland for organ and bone marrow replacements. Roughly 50 organ transplants were done annually in the years before the center’s closing. At its peak in 2005, the facility performed nearly 100 organ replacements a year, he said.
Queen’s is hoping to receive approval in the next few months from the United Network for Organ Sharing (UNOS), a private nonprofit that manages transplants for the federal government, to begin pancreas replacements and eventually heart transplants. The Centers for Medicare & Medicaid Services, or CMS, also must certify organ replacements because Medicare covers renal dialysis and transplants without an age requirement. Queen’s also is considering bone marrow transplants, a service lost when HMC closed.
"We’re slowly building back up and hope to within a couple years be back at our peak," Cheung said. "Moving forward this year, we’re going to try to grow the program and make sure we enhance the quality of services and … be more engaged in the community. We’re going out to dialysis units to talk to patients and staff to make sure they understand the great opportunity we have at Queen’s for transplants here in Hawaii."
Kapahulu resident Douglas Ellis Jr., 69, received a kidney transplant at Queen’s on Aug. 8 after living for nearly a decade with kidney disease. He was on dialysis for five of those years.
"If there was no transplant, you’d stay on dialysis for the rest of your life. It’s hard on your body," said Ellis, who had 3 1⁄2 hours of treatment three times a week. "The more hours you’re on each day, it takes a toll on your body. If you have to go to the mainland, it takes time and costs. Having it here, it’s accessible. For the families of dialysis patients, it’s a big deal."
Besides savings costs of travel, patients have had the support of their families and physicians in the islands with a transplant center at home.
"It just worked out a lot better for me versus going to another place where I know nobody and none of my physicians know what they have done," said 49-year-old Makakilo resident Leslie Henderson, who was given two to three months to live before his Sept. 1 liver transplant. "It was essential that I had it. My condition’s gotten better. I feel great. It’s not just a benefit to me, but to all the people who live in the islands because of the closeness of the facility. I know that I was given a second chance at life."
There are about 350 people on the waiting list for kidneys, roughly the same as when the Transplant Institute closed in December 2011, and another 30 patients waiting for liver transplants, Cheung said.
Rebuilding an organ transplant program from scratch has been a daunting process for Queen’s, which was required to re-evaluate all of the waiting-list patients, which took about six months, and jump through a number of regulatory hurdles to place them back on the list at the new facility, he added.
"Even though we moved the program literally maybe two or three miles, the UNOS and CMS basically looked at it as a whole new program, so we had to basically rebuild the entire infrastructure at Queen’s to help bring these patients through," he said. "We had to have each (patient) come back again for their evaluations, X-rays. In that interim some patients got sicker and were no longer eligible. Others may have passed away from their disease. Some patients went to the mainland and were put on the lists there. There was some loss of patients. That’s why it’s really important to have a program here that remains active so that we don’t lose time and opportunity for those patients."
Hawaii consistently has the longest waiting time compared with the national average because of the higher rate of renal failure and inadequate number of donors.
Most of the organs donated locally each year come from people involved in catastrophic accidents, according to the National Kidney Foundation of Hawaii. Those with chronic diseases such as cancer are ineligible to donate their organs.
The state provided $1.5 million in seed money to help Queen’s quickly launch an organ transplant facility to replace the Pacific’s only transplant hub. The hospital matched the state funds for the estimated $3 million in startup costs, which included hiring staff and building renovations. Still, Queen’s has estimated the facility could produce $7 million to $8 million in losses in the first five years, though Cheung said the financial performance in the first year was better than anticipated.
