KentuckyOne Health will suspend its heart transplant program at Jewish Hospital effective August 17, leaving 32 patients in Louisville, Ky., without a clear path to a new heart.
In a prepared statement issued last week, KentuckyOne spokesman David McArthur called the hiatus a “long-term inactivation” of the transplant program, which suffered in recent months from a lack of patients and struggled to retain cardiologists. In the whole of 2019, McArthur said, the program performed one heart transplant.
Federal regulations require heart transplant programs perform at least 10 procedures over a rolling 12-month period to maintain program compliance. Last year, despite being the only heart transplant program in Louisville, Jewish barely met that minimum.
WKU, the area’s local NPR affiliate, reported July 25 Jewish Hospital attributed its temporary suspension in part to a shift in the way hearts are distributed across the U.S. A new policy, introduced in October 2018, broadened the three risk categories used to triage transplant patients to six, narrowing the number of patients in the highest-need categories. Hearts now go to the sickest patients, regardless of distance.
By the end of 2018, there were 18 people on Jewish Hospital’s heart transplant waiting list, 70% of whom were listed in the second tier. Alanna Morris, an assistant professor of cardiology at Emory University, told WKU that under the new system those patients would likely fall under level four, putting them at a lower priority and resulting in fewer donor hearts being sent to Jewish Hospital.
“If most of their patients were listed at a lower priority status, they may not be as competitive for hearts as other big centers around them that had more patients in the status one [through] status three,” she said.
In an email to his employees July 18, hospital president Ronald Waldridge said the program inactivation will only affect the heart transplant program at Jewish—not any of the other University of Louisville-led solid organ transplant programs that are housed at the hospital nor any other CV services.
According to the Louisville Courier-Journal, the dean of U of L’s medical school, Toni Ganzel, estimated the university had probably lost five to six cardiologists over the past two years and re-hired two or three, resulting in a net loss.
Waldridge told his staff the suspension could last up to a year, and re-launching it would take approval from the federal government and accreditation from a reputable organ transplant organization.
WKU reported patients on Jewish’s waiting list will be transferred to centers that might include the University of Kentucky, Vanderbilt University Medical Center in Nashville or the University of Cincinnati. That could put patients dozens of miles from the hospitals they need to consistently report to for consultations, follow-up appointments and the transplant procedures themselves.
“Patients have to pay the gas money, sometimes hotel stays...there’s a lot of financial investment on the part of patients to be able to engage in this very intensive care,” Morris said. “Even having to drive an hour or two further away certainly can put even greater hardship on patients and families who are already on a difficult journey.”