Children’s Ends Liver Transplant Program
Citing high costs and medical difficulties, Children’s Hospital officials have decided to drop the liver transplant program that they started with Sharp Memorial Hospital 18 months ago.
Last summer, Children’s board of trustees put the liver transplant program on a six-month hold after the state Medi-Cal office refused to finance further liver transplants at the two hospitals after five of the six transplant recipients had died.
On Jan. 30, the Children’s board decided to extend the moratorium indefinitely--in effect, ending the pediatric hospital’s participation in the program, medical director Dr. David Chadwick confirmed Thursday.
The program’s last transplant was performed in January, 1984, on Carolyn DeMille, a 2-year-old Nevada girl who remains the sole survivor of the six transplants, all performed by Dr. Marshall Orloff.
Orloff “thought the program was going OK and wanted to continue it,” Chadwick said. “He has not presented a new proposal to the hospital, but I think his perception is that if he presented another proposal it wouldn’t do him any good.”
The board decided “to continue the moratorium on the program without putting a time on it,” Chadwick said. Asked if that meant the Children’s liver transplant program is dead, Chadwick responded, “I think you could say that.”
“I’m disappointed about it, but at the same time I don’t think we had any options under the conditions,” Chadwick said. “Eventually I’d like to see it done again, but it would require improving the state of the (transplant) art or a better funding climate for doing things that are very, very expensive.”
The DeMille girl lives with her parents in Henderson, Nev., and is “getting along reasonably well,” Chadwick said. “She’s not free of problems--she still has to take cyclosporine,” a drug that prevents her body from rejecting its new liver, and she probably will have to take the drug “until somebody invents something better. She’s not in pain; she’s getting around; she’s intellectually perfectly normal.”
Although disappointed by Children’s move, Sharp Hospital spokesman Ed Crawford said he’s confident that Sharp not only will eventually resume transplanting livers but also will offer heart transplants. Sharp’s liver transplant program has not been active since Medi-Cal money was cut off.
In preparation for the heart transplant program at Sharp, a surgical team has performed several heart transplants on pigs during the last year, two sources have told The Times.
The team, led by Dr. Aidan Raney Jr., has performed the transplants at a UC San Diego animal research facility.
The researchers are honing their skills for the human transplants by removing each pig’s heart and transplanting it into another pig, the sources said.
Both sources insisted on anonymity. One was a surgeon who has helped perform the operations on the pigs.
The researchers are testing devices on the animals such as oxygenators that maintain a high level of blood oxygen and pumps that support blood flow after the pig’s heart has been removed.
The pigs are killed soon after the transplants because a veterinary staff would have to work “around the clock” keeping them alive, one source said, adding that “there’s no blood bank for pigs.”
