The liver transplant program at USC University Hospital in Los Angeles has one of the highest death rates in the nation, with twice as many patients as expected dying after their surgeries, according to data released this week.
The most recent statistics show that 38 USC patients who received new livers from January 2003 to June 2005 died within a year of surgery -- 19 more than expected, according to the Scientific Registry of Transplant Recipients. The agency, which analyzes data on behalf of the federal government, determines the expected rate for each center after adjusting for such factors as patient age and condition and organ quality.
The troubles at USC follow scandals that forced the closure of two other liver transplant programs in Southern California last year: at St. Vincent and UCI medical centers. But USC's reach is far greater: It performed 92 transplants last year, about three times as many as St. Vincent and UCI combined did in any recent year.
A review by The Times shows that the one-year survival rate at USC's liver transplant center, the third-largest in the state, steadily dropped since at least 2002, hitting a low of 75.8% in the new report. That is far below the U.S. average of 86.6%.
Just four adult centers nationally had lower survival rates over the same period.
USC's rate also falls below federal and state standards to receive certification and funding from government programs. The Medicare program requires a raw survival rate of 77%, and the Medi-Cal program demands 80%.
Dr. Rick Selby, director of USC's liver transplant program, said patients should not be alarmed by its survival rate.
"It's clearly not because we don't know what we're doing," he said, noting that the transplant team has remained virtually unchanged in recent years. In fact, for a period, USC's survival rate was above the national average.
"We know what we're doing," he said. "We don't want to be painted with a broader brushstroke as an incompetent program."
The California Department of Health Services said Wednesday that it found the newly released statistics "a concern" and will begin investigating. Meanwhile, the U.S. Centers for Medicare and Medicaid Services, already under fire as lax in oversight of transplant programs, is conducting a broad review of all federally funded centers.
After learning of USC's numbers from The Times, Cheryl Rader questioned the treatment her husband, John, received there.
He received a new liver at USC in June 2005. The transplant was a chance to regain a life derailed by a progressive liver disease -- but John, 64, died 3 1/2 months later of a post-transplant infection.
"He shouldn't have died," his widow said. "It was a tragedy that he died. It shouldn't have happened."
Selby offered various explanations for the program's record -- including a very sick patient pool -- but studies and transplant experts indicate that the reasons offered cannot account for the results.
Dr. John R. Lake, director of liver transplants at the University of Minnesota Medical Center, said the expected survival rate for each hospital takes into account the severity of illness. He also said that with the large number of transplants performed by USC, the results cannot be attributed to chance.
"You have twice as many deaths as expected," he said. "It's pretty hard to chalk that up to bad luck."
Lake chairs the liver and intestinal organ transplantation committee of the United Network for Organ Sharing, the federal contractor responsible for the safety and equity of the national transplant system.
He and other experts expect the group to immediately demand answers from USC and visit the private hospital in Boyle Heights to investigate.
Dr. Goran Klintmalm, head of the Baylor Regional Transplant Institute in Dallas, said the two top liver surgeons at USC are "very good guys. They know the business."
USC Center Is Latest With Transplant Woes
University Hospital has among the nation's highest death rates for those receiving new livers, data show. The state plans to investigate.
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