On March 14, Kristen Jacobs got the call that she thought would save her life.
The 59-year-old financial planning assistant had been on kidney dialysis for three years and was finally getting a transplant.
“We were on the top of the mountain,” said Jim Jacobs, Kristen’s husband, of Hutchinson. “We thought we had it made, and then when she started getting sick, she was checked in the hospital one Friday and died the next.”
Kristen Jacobs died at the hospital on April 27. For three weeks after the transplant, everything had seemed fine until she was diagnosed with an infection that required doctors to remove her remaining native kidney.
After the surgery, she had another infection that Jacobs thinks was acquired in the hospital. He said he is considering legal action against the hospital for his wife’s death.
“I’m still a supporter of the kidney transplant program,” Jacobs said. “This really turned out to be not a kidney transplant issue, but a post-transplant issue. … ” “I believe in the program and so did my wife.”Program suspension
On May 30, Via Christi Health suspended its transplant program after learning that four transplant patients from the past year died within a three-week period and another patient had kidney failure but lived.
Reviews of the deaths showed there were no common threads among the patients, the hospital said, but as a precaution, they halted the program to bring in an outside group to evaluate the program.
In June, the area’s only two renal transplant surgeons – Charles Shield and Anthony Rezcallah – left Wichita Surgical Specialists. Shield retired.
The program, which was started in 1981, had performed more than 1,100 kidney transplants.
The only other hospital in the state that performs transplants is Kansas Medical Center in Kansas City. The other closest programs are in Tulsa and Oklahoma City.
Via Christi officials could not confirm whether Kristen Jacobs was one of the patients whose cases prompted the review because of patient privacy laws, but Jim Jacobs said hospital officials told him her death was among the factors considered when they chose to suspend the program.Future plans
Now, Via Christi is the in process of restarting its transplant program, said Laurie Labarca, chief operating officer of Via Christi Hospital St. Francis.
After the suspension, Via Christi had an outside review conducted by members of the Vanderbilt University Medical Center staff on behalf of Transplant Management Group out of San Diego.
The group looked over the hospital’s program and conducted interviews with the transplant staff. The review team determined that there were no commonalities among the deaths of the patients and all had different causes of death not directly related to the transplants.
The reviewers also made recommendations to Via Christi about its transplant program structure and how it could be improved for more coordinated care.
“I’d do it all over again,” Labarca said of the hospital’s decision to suspend the program until the hospital determined whether the deaths had common contributing factors. “I feel I was part of a decision that makes sense, that was right.”
There were no other patient deaths or organ failures among transplant patients after the suspension was implemented, Labarca said.
“That’s what was so odd. So many out – nine months out, three months out (of surgery). There wasn’t a common gender. Different physicians. It didn’t make sense,” Labarca said of the spate of deaths that prompted the suspension and the review.
The hospital plans to restart the program and is in the process of recruiting two transplant surgeons, a transplant administrator and a transplant nephrologist who would serve as medical director for the program, Labarca said. All would be directly employed by Via Christi.
Labarca said that of the 19 individuals who were a part of the transplant program staff, three are no longer working for the hospital; the rest have moved to other departments.
“We want to relocate them back to the transplant program,” Labarca said. “We want to keep that expertise in place.”
Via Christi continues to provide services for those recuperating from transplants and those who require follow-up care for transplants done before the suspension.
To restart the program without having to go through the entire accreditation process, the hospital will need to have physicians in place by May 30, one year after it suspended the program.
Because the timing is dependent on the recruitment status of physicians, Labarca said the hospital will re-evaluate its timeline in March to see if it will be ready by May 30.Local impact
The suspension of the program has greatly affected area patients, said nephrologist Dennis Ross with Kansas Nephrology Physicians.
“Ideally, it would be best if the transplant program was here,” Ross said. “If (patients) go out of state, whether insurance will cover the transplant becomes complicated. They may have Kansas Medicaid, for example, that does not cover it in Nebraska.”
“Some patients we deem good transplant patients are now saying they can’t afford it or insurance doesn’t pay it. We will take care of them either way, but unfortunately for them, they are left on dialysis.”
Some patients will go to cities where they have relatives they can stay with after the surgery, Ross said, but traveling isn’t easy for patients.
The waiting list for Via Christi’s program had 97 people on it when the program was suspended. Via Christi has worked with those patients to find other hospitals, Labarca said.
“We have an obligation to help those people that were on the list,” Labarca said. “We immediately started working that list to help people transition to another program to be listed somewhere else.”
So far, 31 patients have transitioned to another list. Of those 31, three have had transplants and three are listed with both Via Christi and another facility. Five patients have been removed from the list by themselves or their physician. The rest remain on the list, waiting for the program to be reactivated.
Nationwide, there are currently more than 94,500 people waiting for kidney transplants, according to the Organ Procurement and Transplantation Network.
Most kidney transplants come from deceased donors, and kidneys are the most sought-after organ for transplant in the country.
Via Christi’s program was on track to perform nearly 50 transplants this year.
The program was small compared to moderate programs that do about 80 per year and large programs that do between 120 and 140 per year, Ross said.
There are no other transplant programs in Wichita.
Several years ago, Via Christi had a heart transplant program but closed it when the program did not meet the minimum number of transplants required for accreditation, said Roz Hutchinson, communication and public relations director for Via Christi Health.Patient perspective
Bill Landrum, a vocal and bass guitar instructor at School of Rock, a Wichita music school, received a kidney transplant on Nov. 13, 2007, at Via Christi St. Francis.
He was on the operating table for 11 hours.
He’s concerned about the impact of not having a transplant program in Wichita.
“If I had to travel to Kansas City to get it done, I don’t know if I would have survived,” he said.
“It’s time consuming and the money, traveling, maintaining a job and kids, it took such a strain on family. … Within this city, there has to be a kidney unit that can take care of issues here in Wichita.”
After nearly two years on the Via Christi transplant list, Allison Abedini was near the top of the list when the program was suspended. She’s now on the list at KU Medical Center in Kansas City.
“I was definitely disappointed,” said Abedini, who works for Via Christi Health as a patient service representative. “I think it was definitely a setback. I guess I just think of it as whatever I need to do to get a transplant. It’s a drive to Kansas City, but that’s what I need to do.”
The 25-year-old was born with cystinosis, a hereditary disease that can ultimately lead to kidney failure. Her sister Ashley has the same condition and received a kidney through the Via Christi program last year.
“My perspective is, if you’ve never been through hard times, you won’t appreciate good times,” Abedini said. “I’ll just appreciate being healthy that much more when the transplant comes.”