Danny Jacobs, M.D., is president of OHSU. Sharon Anderson, M.D., is executive vice president and dean of the OHSU School of Medicine. John G. Hunter, M.D., is executive vice president and chief executive of the OHSU health system.
As Oregon’s only public academic health center with statewide missions in patient care, research and education, the temporary deactivation of OHSU Hospital’s Heart Transplant Program was among the most difficult decisions we have ever made. This was the right thing to do at the time, just as reactivating the program is the right thing to do for our patients and trainees.
We recognize, and are deeply sorry for, the distress our patients endured when we temporarily deactivated our program. After ensuring continuity of care for those impacted, we focused intently on identifying and addressing factors that led to program deactivation, and, at the same time, worked to rebuild it based on important lessons we learned after rigorous internal and external reviews. That information was compiled in a public statement, “OHSU Heart Transplant Program: Lessons learned.”
This program, like the other transplant programs OHSU has led in the last 60 years, provides a critically important option for many Oregonians. Transplants are only necessary in the direst of circumstances, when other treatments are unsuccessful or not an option, and transplantation is the only hope to extend life. Because of this reality, all transplants are high-risk, complex procedures, and many factors contribute to their success or failure.
We are proud of our outstanding track record of safety and patient outcomes. Before the temporary deactivation, the OHSU Heart Transplant Program consistently exceeded national standards for one-year survival rates. We are very disappointed that The Oregonian article, “Deaths at OHSU Heart Transplant Program spiked before program shut down,” implies a connection between the deactivation of the Heart Transplant Program with past adverse outcomes. Our voluntary deactivation was entirely unrelated to deaths that occurred in 2017.
In fact, in 2018, before our Heart Transplant Program was temporarily deactivated, the one-year survival rate for patients who received heart transplants at OHSU was 100%. In other words, our Heart Transplant Program exceeded national benchmarks in providing safe, high-quality care.
When a heart transplant patient dies within one year of transplant, the entire health care team at OHSU grieves, and it is standard practice to review what, if anything, could have been done differently for that patient and others to come. The reviews for each patient death included analyses of every possible activity that could have adversely affected patient outcomes, including quality of the organs that were received, and all components of pre-operative preparation, transplantation procedures and the care received after surgery.
Our expert multidisciplinary team found no significant trends of any kind that could be attributed to the unfortunate patient outcomes. Rather, the reasons were determined to be unique to each individual patient -- there was no evidence of systemic issues -- and we fully expect to resume providing exemplary care to our patients when the program is reactivated.
It is devastating when any patient dies, but we also know that other premier heart transplantation programs have years when their outcomes were below expectations, if for no other reason than the complexity of the patient conditions and the procedures.
Our attention is focused on rebuilding the Heart Transplant Program to serve the public with our comprehensive expertise. We are aggressively recruiting advanced heart failure cardiologists from the nation’s leading transplant programs to join our existing team of experts providing comprehensive, leading-edge cardiovascular services, and are very pleased with our progress to date. And, as with all our other programs throughout OHSU, our research in this field will help to deliver life-saving benefits to Oregonians and others around the world.
We are excited to be on track for reactivation and look forward to serving our state, our region and our nation.
This Viewpoint was originally published in The Oregonian on July 21, 2019.