St. Vincent closes its heart transplant unit

St. Vincent Medical Center in Los Angeles has shuttered its heart transplant program, broadening the fallout from a scandal that forced the hospital to stop performing liver transplants last year.

“It was a good program,” said St. Vincent spokesman Paul Silva. “It was just unfortunately presented with some very challenging circumstances.”

Silva said the heart program’s closure, which took effect Oct. 4, was spurred in part by advances in medical devices and drugs that have allowed heart patients to remain alive for years without transplants.

Beyond that, he said, insurers had stopped referring heart transplant patients to the program after the hospital was sanctioned for a host of failings in its now-defunct liver program.

St. Vincent’s heart transplant program had not been identified as having ethical breaches. It had performed between 10 and 14 heart transplants annually, but did only two this year.

Twelve patients remained on its waiting list when it shut down, Silva said, but only one was close to receiving a transplant.

The heart program’s demise is part of a transplant shakeout occurring in California, driven by reports in The Times detailing improper conduct and poor performance at several of the state’s organ programs.

Since last fall, UCI Medical Center in Orange shut down its liver program and Kaiser Permanente closed its Northern California kidney program. The newspaper also has reported on a subpar survival rate for liver transplant patients at USC University Hospital in Los Angeles.

St. Vincent halted liver transplants in September 2005 after admitting that its doctors had improperly arranged for a transplant to a Saudi national using an organ intended for a higher-priority patient on St. Vincent’s medical list. The unauthorized action bypassed dozens of people on a regional waiting list whose conditions were considered more dire.

The hospital also acknowledged that a number of staff members knew about the ethical breach but covered it up.

In March, the United Network for Organ Sharing, the federal contractor that oversees the nation’s organ transplant system, imposed its harshest sanction against St. Vincent -- stripping the transplant center of its “good standing.” It marked the first time that the network publicly sanctioned one of its members.

St. Vincent continues to operate kidney and pancreas transplant programs. For several years, patients in its kidney program died at a higher than expected rate compared with other centers around the country. Recently, St. Vincent improved by becoming more selective about the patients and organs it accepts.

St. Vincent was not the only hospital to see a drop-off in heart transplants this year. Other heart centers in California also are on track to perform fewer than the 12 transplants required by the federal government to qualify for Medicare funding. Yet they continue to receive that money.

UC San Diego Medical Center, for instance, has performed only three heart transplants this year. California Pacific Medical Center in San Francisco has done five.

Dr. Stuart Jamieson, UC San Diego’s head of cardiothoracic surgery, questioned whether a link exists between the number of heart transplants a program performs and its success rate. He said his team has established a long track record of success in heart and lung surgeries.

“Very few centers would still be in business if you applied those strict numbers,” he said, referring to the Medicare requirement. “We’ve been through a dry spell. That just happens.”

A spokesman for California Pacific said three heart patients are currently in the hospital ready for transplants should organs become available.

The program, which performed 14 surgeries last year, expects to have fluctuations in its annual transplant totals, said spokesman Kevin McCormack.

The program’s focus “is quality and not volume,” he said.

The Times reported in June that a fifth of federally funded transplant programs failed to meet the government’s minimum standards for patient survival or performed too few operations to ensure competency. Medicare has said it is reviewing those centers and rewriting its rules.

charles.ornstein@latimes.com

tracy.weber@latimes.com