Probation Urged for UCI Kidney Transplant Unit

The federal contractor that oversees organ transplants nationally has proposed putting UCI Medical Center’s kidney transplant program on probation, after a scandal that forced the closure of the hospital’s liver transplant unit in November.

The move by the United Network for Organ Sharing, outlined in a letter Friday to UC Irvine, would require the Orange hospital to fulfill a host of conditions, including hiring a second full-time transplant surgeon.

In proposing probation, the network’s membership and professional standards committee said “the need for the institution to implement changes is evident.” Like the liver program, the kidney unit had been criticized for turning down a large number of organs offered on behalf of its patients.

The action is all but assured to go through. Dr. Eugene Spiritus, chief medical officer at UCI Medical Center, said the hospital would not appeal the sanction and said he believed it could make the desired changes.

At a Jan. 31 meeting in Chicago, the network’s membership panel had considered more serious sanctions, including one that could have forced the hospital to close its kidney transplant unit. But ultimately, committee members were impressed with the “very thorough and thoughtful presentation” made by hospital officials, the letter said.

Probation would allow the network to perform unscheduled site visits at UCI’s expense, require written proof that problems had been corrected and notify other transplant centers of the move.

The network’s letter comes one day after a panel of experts released a report that found major gaps in leadership and accountability at UCI Medical Center. The committee also found that UCI lacked the resources to match its ambitions and called for a sweeping review of every clinical program.

Spiritus said the kidney program had thrived since Dr. Clarence Foster became its director in July. Foster performed 21 kidney transplants in the second half of the year, compared with nine done at the hospital in the six months before that, officials have said.

“I think we will build a world-class kidney program with Dr. Foster,” Spiritus said.

Before Foster’s arrival, the program accepted only 8.7% of the kidneys offered on behalf of its patients from July 2000 to June 2005, one of the lowest rates in the nation. Many patients on UCI’s waiting list would have had a far greater chance of receiving a transplant had they gone to other hospitals, data showed.

Separately Friday, UCI released a report by the U.S. Centers for Medicare and Medicaid Services that found minor problems based on an overall inspection at the hospital in December. The hospital vowed to quickly mend any gaps in documentation, nutrition assessments, consent forms and building maintenance.

The inspectors did not find major issues that would result in a loss of certification or threaten the hospital’s Medicare funding.

“We were pleased with the outcome of the report,” Spiritus said. “Pleased in the sense that there were no glaring things that put patients in imminent danger.”

UCI has come under scrutiny since it closed its liver transplant program after federal regulators withdrew certification and funding. The Times reported that more than 30 patients on the program’s waiting list died in 2004 and 2005, even as the hospital turned down organs that might have saved some of them.