Success of Las Vegas transplant program lost on pols


I watched as a transplant surgeon - wearing magnifying lenses that enabled him to make the tiny sutures that connect arteries and veins - sewed a new kidney into George McLaurin Jr.

Almost immediately after McLaurin received the kidney in 2009 at University Medical Center, it produced urine and Dr. John Sorensen matter-of-factly delivered the good news to the operating team: "The kidney is working."

Though the procedure appeared flawless, McLaurin did note that the transplant process was not without a complication.

"My dad wanted to sleep in my room that first night to make sure he could tell the nurses if I had any problems," he said. "But he started snoring so loud I couldn't get any sleep."

It was a far cry from the kind of complications, including a death rate more than 50 percent higher than expected, that caused the federal government to rule in 2008 that certification for the UMC center should be pulled.

Only after Nevada's congressional delegation - mainly Reps. Shelley Berkley, Jon Porter and Dean Heller - reacted to public concerns and fought decertification, and UMC committed to a $1 million upgrade of the program, was the program saved.

What's happened with the program since is impressive. UMC's one-year patient survival rate from January 2009 through June 2011 is 97.71 percent - there were two deaths out of 98 transplants - compared with the expected national rate of 96.8 percent.

Since July 2011 there have been 91 more transplants with no deaths.

It's a success story that the politicians who worked to save the program should want to tell. But Karen Hess, UMC's director of transplant services, said none of those public officials have checked to see how the procedures are going.

Sharon Zink, who received a transplant last year, said she was told by kidney doctors that Berkley would probably check on her because she was interested in the success of the program. Zink supposed that she wanted to tout the program's success.

"She didn't show up," Zink said.

How the public often learns about UMC's transplant program today is hardly positive.

It's generally mentioned only in news stories or in Republican Heller's political ads - he's trying to fight off Democrat Berkley's challenge for his Senate seat - that deal with a House investigation into whether Berkley violated House rules by using her position to benefit her husband Dr. Larry Lehrner's medical practice, which includes a partnership in a group contracted with UMC for about $700,000 a year to deliver kidney care, including transplant evaluation.

Berkley, who's said that once the investigation is over everyone will know that her only interest was ensuring that Nevadans have the best possible health care, has noted that she did not officially disclose that her husband was a kidney specialist before pushing against the federal proposal to close the transplant center because she thought "all my colleagues knew that."

I called Lehrner and told his secretary that I wanted to talk about how well the UMC transplant program was progressing. Surely he had shared the good news with Berkley. The secretary checked with Lehrner and I was given the phone number of Berkley's campaign. I called the campaign and left the same kind of message there about reaction to UMC's success. The next day I received a long email from campaign staffer Xochitl Hinojosa that does not address my question, but does purport to show Lehrner benefited little from UMC's transplant program.

"The transplant program makes up just a small portion of the UMC contract with Kidney Specialists of Southern Nevada in which Berkley's husband is a partner," the email reads in part.

Though I had seen the contract and know the truth of the statement, it had nothing to do with Lehrner's reaction to, or possible role in, UMC's success, but so be it.

While Lehrner has nothing to say about UMC's transplant success and seems to do his best to ensure that people tie the financial aspects of his practice to his wife, no one can accuse Heller of saying anything positive about the program. He failed to return repeated calls asking for comment on the turnaround of the program he helped save.

Heller often uses a 2011 New York Times story that refers to UMC in 2008 in his ad campaign against Berkley:

"At University Medical Center here, alarms were set off three years ago - kidney transplants were failing at unusually high rates, and some patients were even dying. Federal regulators moved to shut down the kidney transplant program ..."

The effect of that repeated story, according to UMC transplant surgeon Dr. John Ham and hospital CEO Brian Brannman, is to keep in the public consciousness that the UMC program is in trouble, that people should go elsewhere for kidney transplants.

"If public officials really care about Nevadans," Brannman said, "you talk up a public resource, not try and help tear it down. We now have a program that is shining pretty bright - that's what our representatives should push."

Paul Harasim is the medical reporter for the Las Vegas Review-Journal. His column appears Mondays. Harasim can be reached at pharasim@reviewjournal.com or 702-387-2908.

 

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