Miami Valley Hospital to close Kidney Transplant Center



Miami Valley Hospital confirmed Wednesday it is closing its 43-year-old kidney transplant center because of financial challenges and low patient volumes.

MVH president and CEO Bobbie Gerhart said the hospital on Wednesday notified the Ohio Department of Health and the Centers for Medicare & Medicaid Services (CMS) about its plans to shut down the transplant program by May 13, as required by law. The hospital’s board of directors approved the decision on Tuesday.

Gerhart said the center will continue to perform transplants until the program ends, and staff will remain in place to ensure the transition of patients on waiting lists and those in postoperative recovery.

“We are really concerned about our patients, but there is a plan for communicating with them one-on-one,” Gerhart said. “The priority would be the 90 patients that are currently on the waiting list, and we will transition those in the order they are on the waiting list today to other regional centers of their choice.”

The choices would include the University of Cincinnati Medical Center Cincinnati Transplant Center, The Ohio State University Wexner Medical Center’s Comprehensive Transplant Center in Columbus, The University of Toledo Medical Center, The Cleveland Clinic Foundation in Cleveland and St. Vincent Hospital and Health Care Center in Indianapolis.

In addition to patients on the waiting list, the transplant program serves 1,110 postoperative patients who will continue to receive care at the hospital, and a number of patients having lab work done to prepare for transplants who will have the choice of continuing their work-ups at MVH or transferring to another regional center for lab work, Gerhart said.

The staff of eight full-time clinicians will be offered new positions in other departments after the transplant program shuts down. The director of the program, Dr. R. Brian Stevens, remains under contract with the hospital, officials said.

Gerhart said the program had to be shut down because it simply was not performing enough surgeries to remain fiscally solvent and was losing up to $3 million annually.

Dr. William Rundell, the medical director for the Dayton office of Life Connection of Ohio, an organ procurement organization, and former director of the transplant program at Miami Valley Hospital, lamented the end of the program. He said it is likely to result in longer wait times for transplants at other facilities and force local patients to travel long distances for care.

“It’s not a good thing for anyone,’’ he said.

The average wait time for a kidney transplant at MVH is just over 18 months, compared to national average of about 53 months, according to hospital officials.

While the number of transplants had been growing after the hospital started performing surgeries in 2011 with live donors, instead of just cadavers, the numbers still were not on par with the 100 or more surgeries most regional transplant centers perform every year, Gerhart said.

Last year, MVH surgeons performed 56 transplants — the most ever in one year and up from averages of between 30 and 40 transplants in previous years.

But, “without being able to grow the volume to 100 cases or more and becoming regionalized, we cannot sustain the cost of the program,” said Gerhart, who blamed a lack of organ donations and procurements for preventing the hospital from keeping up with demand.

Compounding the program’s financial constraints are new regulatory requirements from CMS, which regulates transplant programs with high volumes of Medicaid patients such as the MVH program.

CMS would have required the hospital to hire at least four new “highly-skilled” medical professionals and provide additional resources at a cost of more than $1 million a year, Gerhart said.

“We don’t base our care on money,” she said. “But the reality is that the (regulations) are changing in the industry. And because the Centers for Medicare and Medicaid Services and other regulatory agencies are trying to move toward regionalized programs, they are mandating additional resources.”

MVH opened its transplant center in 1970.

The transplant center, as well as the Kidney Dialysis Unit, are located on the third-floor in the west wing of the main building of MVH.

The facility is an integrated center, with all aspects of the kidney program in one space. Surgeons, nephrologists, nurse practitioners, nurses, coordinators, dietitians, social workers and administration are all in one central location to focus on patient care.



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