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Experts Begin Review Of OHSU's Collapsed Heart Transplant Program And Cardiology Institute

Three months after the heart transplant unit imploded, four outside specialists are launching what's called a "peer review," a confidential process that will look at what when went wrong in the unit and the Knight Cardiovascular Institute and make recommendations on how to move forward.
Oregon Health & Science University Marquam Hill campus in Portland. | OHSU
December 9, 2018

When its heart transplant program imploded in August, Oregon Health & Science University promised a peer review to get to the root of the problems that led to the departure of its four heart failure cardiologists and the need to transfer hundreds of patients to other medical centers.


On Monday, that review begins, and it will stretch beyond the heart transplant unit itself. OHSU said in a statement that national specialists in cardiovascular medicine and cardiothoracic surgery will look not only the heart transplant program but also the entire Knight Cardiovascular Institute.


“Reviews and assessments that include a self-study, financial analysis, organizations assessment and external peer review are planned or underway,” OHSU said in a statement. “Faculty and staff input will be essential to every aspect of these comprehensive reviews.”


These assessments follow monthsof shakeups at the institute.


In August, OHSU announced that it was suspending its heart transplant program because it didn’t have enough cardiologists to attend to patients. The program was staffed with four heart failure specialists, who were all gone by the end of September. Then in October, the university announced that the head of the Knight Cardiovascular Institute, Dr. Sanjiv Kaul, would be stepping down at the end of this year, replaced in the interim by Dr. Sharon Anderson, dean of OHSU’s school of medicine. The university gave little explanation of his impending departure, saying he would focus on research.


Kaul was instrumental in the creation and expansion of the Knight Cardiovascular Institute following a $125 million grant from Nike co-founder Phil Knight and his wife Penny Knight in 2012. The institute grew to more than 555 employees, including 125 physicians, nurse practitioners and physician assistants. But the Knights did not second that contribution, as expected. Kaul made some controversial decisions, and the collapse of the heart transplant unit was a public embarrassment for OHSU, coming soon after the new president, Dr. Danny Jacobs, took the helm.


With its heart failure cardiologists gone, the university had to transfer its 20 patients waiting for a transplant out of state because Oregon doesn’t have another heart transplant program. An OHSU spokeswoman told The Lund Report that three have undergone a transplant and that the 15 others are on waiting lists at the University of Washington or other centers. Nearly 350 other patients who had already received a transplant or a ventricular assist device which keeps the heart ticking are being treated at Providence Health & Services. Providence has a robust heart failure unit, with five specialized cardiologists.


“The OHSU heart transplant program team continues to care for and support our patients, in collaboration with Providence, the University of Washington and our community partners,” Dr. Danny Jacobs, OHSU president, said in a statement. “We are grateful for their generous assistance as we work to rebuild a sustainable heart transplant program and structure the Knight Cardiovascular Institute for the long term.”


A spokeswoman for Providence told The Lund Report that the medical system is still in talks with OHSU about the future of heart transplantation in Portland. Providence used to have a heart transplant program. But it appears that OHSU wants to remain the sole provider.


“We are fully committed to reactivating the state’s only heart transplant program for patients in Oregon and beyond,” OHSU said in the statement. “To that end, we have been aggressively recruiting the specialists needed to provide the full continuum of care.”


The peer review team includes four specialists from Northwestern University Feinberg School of Medicine, the University of Wisconsin Health, Duke University School of Medicine and Emory University School of Medicine. The Lund Report emailed the four reviewers, asking them about the review process in general and whether they had any ties to OHSU. Two -- Dr. J. David Vega and Dr. Joseph Rogers -- replied, saying the review process is confidential.


The OHSU statement said the review is exempt from public disclosure but that it would share updates with the public, as appropriate.


It’s not clear how long the review will last or whether the review team will interview the four heart failure cardiologists who left the heart transplant team, causing it to collapse.


The statement said recommendations from the peer review and other assessments will help the leadership determine the future leadership, structure, scope and direction of the various missions of the Knight Cardiovascular Institute.


You can reach Lynne Terry at [email protected].