Transplant Patient a 1st for Sharp

A 39-year-old San Diego woman was in Sharp Memorial Hospital Thursday night, awaiting an operation to become the first Medi-Cal-covered heart transplant recipient at the hospital.

Elated officials announced this week that their 3 1/2-year-old heart transplant program had qualified to become only the third hospital in the state where poor people can receive state-funded heart transplants.

The approval means greater availability of heart transplants to San Diegans who qualify for Medi-Cal operations but can’t afford the extended post-operative stay near the other two centers, at UCLA Medical Center and Stanford University.

In March, a community fund drive made it possible for one such patient, 19-year-old LeNora Flowers, to have a heart transplant. Earlier in the program, another Medi-Cal patient’s operation was paid for by an anonymous benefactor.

The approval, which was effective May 1, made it possible for Tonda Thomas to be admitted to Sharp Wednesday instead of having to go to UCLA for a heart transplant.

“She’s obviously elated to be able to stay at home,” hospital spokeswoman Cindy Cohagen said. “She was looking at having to move into some sort of board-and-care facility after her transplant so she could be close to the hospital in L.A. She has three children. Now she’ll have the opportunity to stay at home with her family.”

Being with family members helps transplant patients adjust to the extended recovery period and life-style changes--for instance, a lifetime of taking anti-rejection drugs.

“That support group is really, really important, as they work through the recovery period from the transplant,” Cohagen said.

After a nearly 2-year application process, state approval came because Sharp had clarified some aspects of its program that had been in question before, said Tom Elkin, chief of the medical benefits branch for the California Department of Health Services.

Those were technical details having to do with staffing and support services, Elkin said. Although the approval was labeled provisional, he said he didn’t expect any problems in giving full approval as details are further clarified.

There was never any question that Sharp would meet the state Medi-Cal funding standards for survival of its heart transplant patients, Elkin added.

The state requires that a hospital perform at least 10 transplants a year with a one-year survival rate of 75%. Sharp has performed the operation on 30 patients since the program began Oct. 11, 1985, with a survival rate of 90%.

“Part of the reason the approval took so long is that many of the patients that had had heart transplants, a year hadn’t expired yet,” Elkin said. “So to get the numbers up there, we had to wait.”

Elkin added that the state will have just three Medi-Cal-approved heart transplant centers for the near future, because no applications are pending from other institutions.

Within the San Diego area, however, three other hospitals are considering establishing heart transplant programs. They are Mercy Hospital, Scripps Clinic and Research Foundation and UCSD Medical Center. UCSD Medical Center would use the same surgeons as Sharp.

Peter K. Ellsworth, president and chief executive officer at Sharp, said the decision will greatly improve the lot of transplant patients in the San Diego area. He called it “a major step in providing affordable, quality care for this community.”

Cohagen said hospital officials have no idea how many Medi-Cal patients might be candidates for inclusion in the Sharp program. Only one Medi-Cal patient is on the hospital’s waiting list now, but others might switch from UCLA or Stanford because of longer waiting lists there, she said.

“In a population of 2 million people, you would think that there will be people who would come here now,” she said. “And there may be patients in other parts in Southern California who would come here.”