UPMC transplant center reopens after two months

By Andrew Shull

After being closed for more than two months, UPMC’s Living Donor Kidney and Liver Transplant… After being closed for more than two months, UPMC’s Living Donor Kidney and Liver Transplant Center has permission to re-open immediately.

The center has been closed since May 12 after a patient received a kidney infected with Hepatitis C from a live donor.

UPMC announced in June that they had demoted a doctor and suspended a nurse as a result of the incident. But UPMC will not release the names of the individuals.

Jennifer Yates — a UPMC spokeswoman — confirmed that the Living Donor Transplant Center had re-opened after a United Network for Organ Sharing committee met in Chicago Thursday to review UPMC’s case. The network is a private, nonprofit organization that manages the nation’s organ transplant system under contract with the federal government.

“We are eager to get back to doing what we do best, which is serving patients and providing the highest quality [of] care,” Yates said in an email.

UPMC’s website details the screening processes for donors. In addition to screening for infectious diseases, patients will also undergo a physical examination, a review of medicines they are taking, blood tests, tissue typing, an electrocardiogram, chest X-rays and even psychological counseling.

This screening process makes the situation at UPMC a very rare one. The UPMC website for living-donor kidney transplantation explicitly mentions that the medical center screens for HIV and hepatitis. But there is no national standard for testing transplant organs, each hospital sets its own.

Anne Paschke, a spokeswoman for the UNOS, said that the nonprofit would only discuss an investigation if it put a member on probation or deemed it to be “not in good standing.”

Paschke said that though she couldn’t confirm the existence of the investigation, neither action was taken against UPMC.

The original press release from UPMC in May named the UNOS as one of the bodies investigating the incident, and Yates said the UNOS gave UPMC the go-ahead to re-open immediately.

The Pennsylvania State Department of Health also completed an investigation of UPMC. Christine Cronkright — the Department’s press secretary — confirmed that it had concluded its investigation and that UPMC submitted a “plan of correction,” which UPMC plans to make available online in early August.

Cronkright was unable to provide any specifics at this time on the investigation or the plan of correction.

Yates also said that UPMC has introduced “redundancies” in its screening process to prevent a similar issue from arising again. The transplant center — which UPMC voluntarily closed for the duration of the investigations — has performed over 600 living donor transplants since 2002, when living donor transplantation became available at the hospital.

Yates would not say how many transplants had been postponed due to the closing.

Even prior to the incident, UPMC’s website explicitly said that they test for HIV and Hepatitis as part of the intensive screening process that all patients go through before receiving an organ.

While incidents like this are rare, they aren’t necessarily unheard of.

Statistics provided by the United Network for Organ Sharing show that from 2005 to 2010, there were nine cases of Hepatitis C transmission due to organ donation. One of those incidents resulted in a patient’s death.

Sue Simon, the president of the Hepatitis C Association characterized the test for Hepatitis C as “excellent.”

Simon also said that Hepatitis C — while it is the most recent variation of the virus— is the most dangerous, as it becomes chronic 70 percent of the time. In contrast, Hepatitis A is self-remitting, and Hepatitis B only becomes chronic 10 percent of the time.

Of the three types, Hepatitis C is also the only one that doesn’t currently have a vaccine.

The Hepatitis virus attacks the liver, and it damages the organ by causing scarring. Given enough time, Hepatitis can cause cirrhosis, which the NIH’s website defines as a life-threatening scarring of the liver and loss of function.

Simon said the most common way for Hepatitis C to be transferred is through contaminated needles. Hepatitis C — unlike Hepatitis B — is not often transmitted sexually, as Hepatitis C is only transmitted via blood and not through any sexual fluids.

Prior to 1992, blood transfusions were also a common route of infection. Until 1989, doctors thought that Hepatitis C was benign, and referred to it as Non-A, Non-B Hepatitis.

According to the Center for Disease Control and Prevention, 3.2 million people in the U.S. are infected with Hepatitis C.