Louisville’s Human Organ Transplant Program Stagnates As Lexington’s Grows

Financial and operational stresses at Jewish Hospital likely to be taking a toll on one of the headline partnerships between the Hospital and the University of Louisville. Increasing dependence on Medicaid patients and a blossoming load of uncompensated care may be blocking access for the medically indigent and recipients of color for at least some solid organ transplants such as heart and liver.

Since the middle 1980s when I came to Louisville, Jewish Hospital has branded itself as a high tech “Heart Hospital.” It promotes the early adoption of high-technology. Indeed, a few years ago it received a special designation as a heart hospital in Kentucky from U.S. News & World Report that it would not have received had it not had a cardiac transplant program. In the middle 1990s, the University of Louisville formally shifted the private practice activities of its cardiologists to Jewish Hospital. The transplant surgeons at Jewish, to my knowledge, all have formal University faculty appointments. Jewish Hospital and the University of Kentucky Hospital are the only two hospitals in the state with a Certificate of Need (CON) for adult human solid-organ transplantation. (The University of Louisville does not own this CON for transplant.) Accordingly, this high-profile program is both important for, and a marker of the institutional health of both Louisville institutions.

For this and for other reasons, I have been writing about Kentucky’s transplant programs for the last few years. Most medical schools with a major clinical medical center consider having a transplant program as an important part of their service profile. I became concerned that although in the 1990s through 2010, Jewish Hospital performed the most such organ transplants in Kentucky, that a steadily-growing UK program overtook our own as early as 2010. My academic pride was injured. My concern included that a weakening Jewish Hospital was losing the resources or the will to continue this important program. It is after all an expensive undertaking. Continue reading “Louisville’s Human Organ Transplant Program Stagnates As Lexington’s Grows”

Kentucky to the World Presents Louisville Native, Dr. Sander Florman.

Noted transplant surgeon to speak March 12.sander-florman

Dr. Florman, a graduate of St. Francis School and University of Louisville Medical School, will share the fascinating story of his journey from growing up in Louisville, to rebuilding the transplant program in post-Katrina New Orleans, and to leading the Recanati/Miller Transplantation Institute at The Mount Sinai Medical Center in New York City.

Kentucky to the World (KTW) showcases highly successful individuals with strong Kentucky connections who are seldom seen or heard here.  Dr. Florman’s work as the Director of the Transplant Institute at Tulane University in New Orleans earned him recognition as one of New Orleans Magazine’s “People to Watch”. He was twice named “Health Care Hero” by New Orleans CityBusiness and was chosen as one of Gambit Weekly’s “40 Under 40.” He was recognized by Louisiana Life magazine as one of Louisiana’s “Top Doctors” and “Best Doctors” in 2007-2009. Florman is the author of nine book chapters and more than 75 publications.


Continue reading “Kentucky to the World Presents Louisville Native, Dr. Sander Florman.”

Who Pays for Human Organ Transplantation?

In response to a recent article in these pages about human organ transplantation in Kentucky, it was alleged that the University of Kentucky Hospital accepted Medicaid as payment for solid organ transplantation but that the Jewish Hospital program did not. I interviewed a number of individuals with first-hand knowledge but was unable to dispute the assertion that the source (or lack thereof) of a patient’s health insurance makes a difference in who receives an organ— not only here in Kentucky but nationwide. I recently obtained comprehensive payer-specific information from the United Network for Organ Sharing (UNOS)– the government-sponsored organization that regulates and oversees virtually all organ transplants performed in the U.S. The short answer is that there is a considerable difference in the payer-mix for solid-organ transplantation between Jewish Hospital and the University of Kentucky (UK). In 2013– the last year for which a full 12 months of reporting is available– Medicaid beneficiaries made up 6.4% of all transplant recipients at Jewish and 15.9% at UK. These figures can be compared to the national proportion of 8.7% Medicaid beneficiaries. It cannot be said that the Jewish Hospital program does not accept Medicaid beneficiaries altogether. Additional details and commentary concerning local and national transplant programs are presented below. Frankly, I had not encountered such data before and I think it will be of general interest to many. Continue reading “Who Pays for Human Organ Transplantation?”

Twenty-six Years of Human Organ Transplantation in Kentucky.

A few days ago I wrote once more about human organ transplantation in Kentucky. No sooner had my bytes hit the ether than a long inked piece featuring the latest hand transplant at Jewish Hospital appeared in the Courier Journal. The article had earmarks of the “press-release” method of media access including a big front page color photo of the surgical suite and the patient. There is no doubt that reattaching limbs to their original owners (or to a new host) represents a spectacular technical accomplishment. Such operations usually make the news somewhere. Continue reading “Twenty-six Years of Human Organ Transplantation in Kentucky.”