USC liver transplant program's high death rate to be investigated

Transplant News, July 19, 2006

The liver transplant program at USC University Hospital in Los Angeles has one of the highest death rates in the nation, with twice as many patients as expected dying after their surgeries, according to data released this week and reported in the Los Angeles Times.

Thirty-eight USC patients who received new livers between January 2003 and June 2005 died within a year of surgery - 19 more than expected, according to the Scientific Registry of Transplant Recipients. The agency determines the expected rate for each center after adjusting for such factors as patient age, condition and organ quality. review by The Times shows that the one-year survival rate at USC's liver transplant center -- the third-largest in the state -- steadily dropped since at least 2002, hitting a low of 75.8 percent in the new report. That is far below the U.S. average of 86.6 percent. Just four adult centers nationally had lower survival rates over the same period.

USC's rate also falls below federal and state standards to receive certification and funding from government programs. The Medicare program requires a raw survival rate of 77 percent, and the Medi-Cal program demands 80 percent.

Rick Selby, MD, director of USC's liver transplant program, said patients should not be alarmed by its survival rate: "It's clearly not because we don't know what we're doing," he said, noting that the transplant team has remained virtually unchanged in recent years. In fact, for a period, USC's survival rate was above the national average.