OHSU's Heart Transplant Team Collapses

All of the heart failure and transplant cardiologists at Oregon Health & Science University will be gone by the end of September.

SEE UPDATE POSTED AUG. 31.

Oregon Health & Science University's heart failure and transplant team has basically collapsed, with all of its cardiologists being forced out or leaving.

There were four specialists on the team. By the end of September, there will be none.

Dr. Jill Gelow, left OHSU after adopting her son and got hired at Providence Health & Services on July 30. Dr. Jim Mudd, the lead cardiologist on the team, is leaving at the end of September. Sources told The Lund Report that his boss, Dr. Joachin Cigarroa, had indicated he would not renew Mudd's contract. Dr. Jonathan Davis, fed up with having to be on-call every other night because of short staffing, decided to flee. That left just one cardiologist, Dr. Divya Soman. OHSU said in a statement on Wednesday that she, too, is leaving. 

Nearly 350 patients will be affected, including 20 on the waitlist for a donor heart and four others awaiting evaluation. Another 327 are in various phases of aftercare.

For patients, the news is devastating.

"The whole team is gone," said Dennis Schultz, who had five heart operations at OHSU, including a transplant. "This is absolutely terrible."

"It’s the patients who will get hurt. They are all excellent doctors," Schultz added. "They put the patient before anyone else."

Last Friday, three OHSU leaders told staff in an internal memo that it was suspending its heart transplant program for two weeks because of staffing issues.

"The decision was made following the departure of one specialist and the planned departure of two others from the heart transplant program team," the email said. "The remainder of the program team will continue to work and actively care for patients."

Now Soman is leaving, too.

The shutdown follows similar action in Houston. In June, Baylor St. Luke's Medical Center suspended its heart transplant program following two deaths, the Houston Chronicle reported. That decision followed reports that in recent years the program had performed an outsized number of transplants resulting in deaths and had lost several top physicians.

At OHSU, officials said they are working to ensure patients are cared for and have reached out to other transplant programs, including at the University of Washington in Seattle, to "expedite the transition" to another program. The university said that patients will get credit for the time they've been on the OHSU waitlist, along with other criteria.

The unusual decision to suspend a life-saving program follows a series of top management changes at OHSU. In April, Mitch Wasden resigned after serving just over a year as the university's head of health care. Wasden, who made just under $1 million, was hired after a nationwide search. The university said he resigned “personal and family reasons.”  

Then in July, Dr. Sharon Anderson, dean of OHSU’s School of Medicine, told Dr. Jeffrey Kirsch, the head of OHSU's department of anesthesiology and perioperative medicine, to step down. He has been replaced temporarily by Dr. Stephen Robinson, currently vice chair for clinical anesthesia in the department. The university is conducting a national search for a replacement. Kirsch's demotion to a faculty position has not been explained and has angered colleagues, sources told The Lund Report.

In August, Dr. Danny Jacobs took over as president of OHSU, following the resignation of Dr. Joe Robertson, who announced his retirement last year following a diagnosis for multiple sclerosis. Jacobs indicated to The Lund Report that he does not plan any immediate changes.

The email on the program suspension was signed by three officials: Hunter;  Dr. Renee Edwards, chief medical officer of OHSU Healthcare; and Cigarroa.

OHSU's heart transplant program is just over 30 years old. According to data from the Scientific Registry of Transplant, the university performed 30 heart transplants between 2015 and 2016, followed by 23 the following year. The data show that demand at OHSU is higher than the national average and that proportionally twice as many die waiting for a transplant compared with the national average -- 17 percent at OHSU compared with 8 percent nationally.

Heart transplantation is the best treatment for end-stage heart failure, with a median survival of 10 to 15 years. One man, who had the operation in 1982 in London and was given five years to live, died 33 years later.

At OHSU, outcomes are "as expected," according to the registry.

The operation itself is considered fairly easy. But there are fewer donor hearts available than patients in need. 

Besides Seattle, the other nearest heart transplant centers are in Spokane and San Francisco. 

Though the email said the program would be halted for two weeks, it's unclear how the university can bring high-level heart failure specialists on board by then -- or even within months.

The suspension of the heart program does not affect the liver, kidney or pancreas transplant programs at OHSU, the university said.

Reach Lynne Terry at [email protected].