Study Rates Transplant Centers

Offering a wealth of new data for transplant patients, a government report documents striking differences among hospitals in the likelihood patients will die while waiting for a new heart or liver.

It's the first study to examine survival rates of all patients who enter transplant waiting lists, offering a head-to-head comparison of 106 liver and 128 heart transplant centers.

"If you're a patient, your chances of survival depend enormously on where you get your transplant," said Rep. Henry Waxman, D-Calif., who requested the data from the Department of Health and Human Services.

At the University of Kansas Medical Center, 89 percent of people awaiting liver transplants got them within a year. But in Baltimore, just 21 percent of patients at the University of Maryland and 23 percent at Johns Hopkins Hospital got them in a year.

There were some disparities even among transplant centers in the same cities, though these differences were generally less pronounced than regional variances.

In Boston, for instance, about 18 percent of liver patients at Massachusetts General Hospital and 17 percent of patients at the New England Medical Center died while waiting. But at Beth Israel Deaconess Medical Center, also in Boston, the figure was 33 percent, the report found.

Officials cautioned that patients must consider many factors when choosing a transplant center.

"It should prompt questions rather than conclusions," said Campbell Gardett, a spokesman for the Department of Health and Human Services.

"This answers the questions a transplant patient would have: Will I get a transplant? Will I be alive a year from now?" he said.

Several factors explain the national variation, experts say. They include policies for distributing scarce organs, a community's willingness to donate and the effectiveness of the local organ bank in collecting organs. They also include a transplant surgeon's medical skills both in keeping patients alive while awaiting organs, and in operating on and treating those who get transplants.

The report is being released Thursday, just as legislation remaking the nation's transplant policies was expected to pass the House Commerce Committee. That bill, strongly opposed by the Clinton administration, would severely curtail the administration's power over the transplant network. It also would allow the network to keep data like that in the new study secret from everyone but transplant patients.

The report includes data through early this year that cover all patients who came onto the transplant waiting list between April 1994 through the end of 1997. It was reviewed by experts in the field, including officials from the United Network for Organ Sharing, which collects the wealth of raw data from transplant centers.

"You need to use this with a combination of a whole host of information," cautioned network spokesman Bob Speilbruner.

The network also produces data on patient survial, but only among those patients who receive transplants. This is the first report to factor in a patient's chances of getting an organ in the first place.