New Mexico Transplant Programs' Future Concerns Some

By Jackie Jadrnak

Journal Staff Writer

The suspension of liver transplants at University Hospital has some officials worried about the fate of other transplant programs in the state.

Federal regulations that sent livers to the sickest people nationwide and dried up the supply in New Mexico may expand to cover other organs, said Maria Sanders of New Mexico Donor Services.

"That's why we were so against the national sharing of organs. It's going to affect the small programs," she said.

The final decision on the fate of New Mexico's only liver transplant program is still 30 to 60 days away, according to Steve McKernan, chief executive officer for University Hospital.

But he didn't have many hopeful words for the liver program in an interview this week.

"We would want to have a quality program," McKernan said, adding that a number of obstacles stand in the way.

University Hospital suspended liver transplants earlier this month as numbers of donors and transplants kept falling. Plus, its primary transplant surgeon announced he was leaving later this year.

From 19 transplants in 1998, the program fell to 11 last year and three so far this year.

The number of heart transplants in the state isn't much higher. Presbyterian Hospital, which runs the only heart transplant program in New Mexico, does about 10 heart transplants a year, according to Cindy Moore, registered nurse and transplant coordinator there. It has done four so far this year.

The number of heart transplants has dropped in the last couple of years because the hospital isn't getting as many donations as it has in the past. That problem hasn't been caused by national regulations--local recipients still get priority for local organs--but by a decline in donations, Moore said.

She said the federal government is reviewing the heart transplant program but hasn't proposed any changes.

One limitation is that hearts are usable for only three to five hours after being taken out of a body, she said. In comparison, livers can be preserved for up to 24 hours, and kidneys can be kept on ice for 36 to 48 hours, she said.

Presbyterian Hospital occasionally has received hearts from Arizona for transplants, but doesn't often send hearts from Albuquerque to another state, she said.

"I think everybody is worried," Moore said of potential program changes. "Right now, my primary concern is having (enough) local donors for transplant recipients."

Two New Mexicans are waiting for donor hearts.

Kidneys already are distributed through a national sharing program, Moore said. But local officials aren't as worried about problems in maintaining local kidney transplant programs, which are based at Presbyterian and University Hospital. New Mexico does 40 to 50 kidney transplants each year, and that's just counting the organs that come from cadavers, Sanders said.

Fifty to 60 percent of kidney transplants at Presbyterian come from living donors, Moore said. Since people have two kidneys, they can donate one without dying--unlike hearts and livers.

University Hospital probably does 25 to 30 kidney transplants per year, McKernan said. "I don't think so," he answered when asked if that program was endangered.

Unlike the liver program, University Hospital has Medicare certification for its kidney transplants, he said. That means Medicare, a federal health insurance for people who are over 65 or disabled, will pay for the transplants.

University Hospital had submitted a request to get Medicare certification for the liver program but has not heard back yet, McKernan said. It met the requirement for doing at least 12 transplants for two years in a row, but then the numbers started falling soon after, he said.

Without that certification, Medicare patients are sent out of state for liver transplants.

To continue the liver program, University Hospital would need Medicare coverage for the operation and to see changes in the federal regulations that are sending livers out of New Mexico, he said.

There is no indication either would happen anytime soon.

"It's a good therapy for a very serious disease, so we'd like to be involved in a (liver transplant) program," McKernan said.

The suspension of the liver program doesn't mean that organ donations have stopped in New Mexico, Sanders stressed.

"There's a lot of confusion in the general public," she said. Even if New Mexicans have to go to another state, they and others still need the organs for transplant.

Copyright © 2000 Albuquerque Journal.

This article posted July 23, 2000.