Hoag to Start County’s First Heart Transplant Program

Orange County’s first heart transplants will be performed at Hoag Memorial Hospital Presbyterian, making the Newport Beach medical facility the fifth in the state to perform the sophisticated procedure, hospital officials said Tuesday.

The program will be headed by Drs. Aidan A. Raney Jr. and Douglas R. Zusman, who were previously on the staff at San Diego’s Sharp Memorial Hospital, where they performed 17 successful transplants beginning in October of 1985.

Raney and Zusman, who arrived at Hoag on Feb. 1, said they will need anywhere from six to 18 months to lay the groundwork for their first transplant here. The time will be needed to remodel some of Hoag’s operating and recovery rooms to accommodate the special needs of transplant patients and to train the nursing and support staffs for the complicated procedure.

“As soon as we feel comfortable doing routine heart operations in this setting and get the hospital’s cardiac program back up to speed, then we will go to step two,” Raney said. On Tuesday morning, he and Zusman completed sextuple coronary bypass surgery on a 69-year-old man, the team’s first surgery as Hoag staffers.

Although acknowledging that the move will attract attention in the competitive Southern California health services market, Hoag officials said it was not the hospital’s intention to start a transplant program. The idea came about, they said, when they were forced to look for cardiac surgeons to replace the six-man surgical heart team that had left Hoag last September.

“In the process of interviewing top-flight surgeons to replace them, Dr. Raney and Dr. Zusman were chosen by the search committee,” said Hoag’s executive vice president, Larry Ainsworth, adding that the two physicians agreed to come work at Hoag as long as they would be able to continue performing heart transplants.

“It’s an added bonus, frankly, that we are going to be able to offer heart transplants for Orange County patients,” Ainsworth said.

Peter Foulke, Hoag’s senior vice president, said the departure of the hospital’s heart surgery team resulted from “conflicts” its members had with the hospital staff’s cardiologists. Foulke, who described the former Hoag team members as “excellent surgeons,” said they have since moved to Saddleback Community Hospital in Laguna Hills.

Administrators said Tuesday that it was too soon to know how many people eventually will undergo heart transplant surgery at Hoag Hospital but that they are confident that such a program can succeed in Orange County.

“The current size of Orange County and its projected growth would justify a heart transplant program,” Raney said. He noted that Orange County transplant candidates now have to travel either to San Diego or Los Angeles for the operation.

According to John Weeks, a spokesman for the American Heart Assn., there are only four other medical facilities in California that perform heart transplants--Stanford University, UCLA, Sharp Memorial Hospital in San Diego and Pacific Presbyterian Medical Center in San Francisco.

‘Big Commitment’

“This is a big commitment for the hospital,” Foulke said. Given the stiff competition to lure patients, he said the transplant program will differentiate Hoag from the other eight Orange County hospitals that perform open-heart surgery and will make the hospital a regional draw.

Said one Hoag official: “The hospital that has the heart transplant service is, rightly or wrongly, viewed by the clinical and lay public as commanding a state-of-the-science edge. People love the high-tech appeal. The heart transplant is still so mysterious, so captivating. . . .”

The move could prove to be a risky one, however, according to a hospital official who asked not to be named.

“It’s a mixed bag to start up a transplant program because it is very taxing on the base operation of the hospital,” he said, explaining that transplants take away critical care beds and make large demands on the hospital’s laboratory and pharmaceutical services.

Referring to the prestige that Humana Hospital in Louisville, Ky., gained after basking in the national spotlight after its pioneer heart transplants, the official added, “You have to decide whether its worth disturbing the base operation of the hospital in order to get that ‘halo effect.’ ”

Both in 30s

Raney, 39, and Zusman, 36, have each served as chief residents under the nationally renowned heart surgeon Dr. Norman Shumway at Stanford University Medical Center. Most recently, the two directed the cardiac transplantation program at Sharp Hospital and UC San Diego, where they were faculty members.

Raney, a native of Southern California, graduated from the USC School of Medicine and completed his residencies at Stanford University Medical Center in 1981.

Zusman is a native of Michigan and a graduate of Yale Medical School.

Between them, they have performed 75 heart transplants in the last several years, Raney said.

The two surgeons have also been trained in using the Jarvik-7 artificial heart and hope to get approval to use the device as an “assist heart” for the dying patient who awaits a donor heart replacement.

Hoag Hospital’s Orange Coast Heart Institute welcomes new transplant team. View, Page 3.