University Of New Mexico Halts Liver Transplants

By Jackie Jadrnak

Journal Staff Writer

New Mexicans who need a liver transplant will have to start looking out of state. University Hospital has suspended and may eliminate its transplant program, the only one in New Mexico.

The hospital simply hasn't been getting enough organs to support a liver-transplant program, said Donald Fry, chairman of the department of surgery at the University of New Mexico's School of Medicine. He said Friday that he suspended the program a week ago and recommended to higher officials that it be dropped.

New Mexico has 26 people on its liver-transplant waiting list.

"It is with a great deal of pain that I've had to come to this point," Fry said, adding that he is the one who started the liver program at UNM in 1994.

"I believe a liver-transplant program is essential to the people of this state," he said. "I think we have a real need." New Mexico has one of the highest rates of hepatitis B and hepatitis C, major causes of liver failure and the need for a transplant.

But a transplant program is not workable because the number of donations has gone down and because a change in federal Health Care Finance Administration rules has been sending more organs donated in New Mexico to recipients in other states, Fry said.

At least some of the 26 people on the state's waiting list were called Friday and were told that the transplant program was suspended.

Their next chore is to see what their insurance will cover and where else they can get on a waiting list. People most likely will be looking to Los Angeles, Dallas and Omaha, because those cities have the largest programs in this part of the country, Fry said. A person's place on those lists would depend on how sick he or she is.

"It was pretty discouraging," said Margarita Haury of Albuquerque, who received such a call Friday from UNM. Her husband, Rick Haury, has been on the liver-transplant waiting list at UNM for about a year.

Rick Haury, 46, said he has cirrhosis, but the cause is unknown. "I never had hepatitis. I don't use drugs. ... I'm not an alcoholic," he said. He said he still is able to work, but he gets tired more than he used to. Haury is a special agent with the state Attorney General's Office assigned to a drug task force.

"I don't know if I want to leave Albuquerque," he said of the prospect of waiting for a transplant in another state. One daughter is a junior at UNM, and another will be starting college in Spokane, Wash., in the fall, he said.

"There are a lot of things we're going to have to think about," Rick Haury said.

"I have to believe it will be OK and will work out," added Margarita Haury.

Late last year, federal regulations took effect that required livers to go to the sickest people, whether they lived in the state where the organ was donated or not. At the same time, liver donations in New Mexico were dropping, according to Maria Sanders of New Mexico Donor Services.

So far this year, 10 livers were donated in New Mexico. Nine were shipped out of state and one was transplanted locally, she said. "I just feel so sorry for the people who can't afford to go somewhere else," Sanders said.

While insurance often covers the medical costs of a transplant, families often have to dig into their own pockets to pay the cost of traveling to and living in another state, she said.

Sanders added that this is just another sign of a medical crunch in New Mexico. "We're going to be moving into survival mode, where we will see transplants as being a luxury," she said.

University Hospital performed 19 liver transplants in 1998, enough to keep the program afloat financially. That number dropped to 11 last year, and only three have been done so far this year, Fry said.

The costs are for paying the salaries of surgeons and other staffers specifically trained for the program, but then not using them for transplants. Plus, if they don't do enough transplants, their skills can get rusty. Fry estimated his department is losing $200,000 on the program each year, and that doesn't take into account hospital costs.

This was going to be the make-or-break year for the program, then program director Bijan Eghtesad announced a week ago he was resigning effective in November to take a job at the University of Pittsburgh. Fry said that announcement led him to suspend the program and recommend its elimination.

Fry said the final decision on the program would be made by Phil Eaton, vice president for health sciences, in consultation with Steve McKernan, chief executive officer of University Hospital, and Paul Roth, dean of the medical school.

All three men were out of town Friday and couldn't be reached, according to Sam Giammo, spokesman for the Health Sciences Center.

Eghtesad declined through Giammo to be interviewed for this story, but he explained some of his reasons for leaving in an e-mail to the local chapter of TRIO, the Transplant Recipients International Organization.

TRIO published his message in a recent newsletter.

It read, in part: "This decision was made mostly because of multitude of problems that I was facing. Increasing frustration because of organ unavailability and also HCFA (Health Care Finance Administration) rules on mandatory sharing and as consequence problems in patient care and increasing death on the waiting list.

"It might be better for the NM patients to be transferred to other programs to have a better chance to get a liver transplant."

Rick Haury said he can understand the reason for the federal rules, which are sending organs to the sickest patients first. "If I were in intensive care, and only had a short time, I would want to get a liver right away," he said.

"Closing the program (at UNM) was kind of a shock, because it was good that I was going to be able to be here (for a transplant). It's kind of a shame," he said.

"You do wish more people would donate organs."

Copyright © Albuquerque Journal.

This article posted July 19, 2000.