Toward the end of last year, reports surfaced on the shortcomings of the UC Irvine Medical Center’s Liver Transplant Program. While the investigation of the liver transplant program continues, documents obtained by the Orange County Register reveal similar weaknesses in the UCIMC’s Bone Marrow Transplant Program. The records reveal that the center has not met state standards for 10 out of its 11 years.
In order to receive Medi-Cal funding from the state, transplant programs must perform 10 transplants a year with a patient’s own marrow and 10 with donated marrow. UCIMC’s bone marrow program met the requirements only once, in 1997. The number of transplants declined beginning in 1999, causing concern among state health officials.
In 2002, the State Department of Health Services informed the hospital of its failure to meet state minimums for transplants performed. According to the OC Register’s documents, Fulton Lipscomb, chief of medical policy for the state health department, wrote the Medical Center’s interim director asking for a plan of corrective action. He found the hospital’s plans to turn the program around in a year vague and insufficient.
Instead of using the opportunity to make changes, the hospital withdrew from the Medi-Cal payment program. The following year, the number of transplants performed dropped to two.
Unlike California centers performing 50 to 100 transplants annually, the UCIMC performs an average of fewer than 10 transplants a year.
Despite the low number of transplants performed annually, the Medical Center is proud of the high success rates of its bone marrow transplant patients.
‘UCI is justifiably proud of its ability to provide comprehensive care to individuals suffering from blood and other cancers,’ the center said in a recently-issued statement. ‘Since 2001, UCI has transplanted 43 patients and demonstrated excellent patient outcomes. Forty-two out of the 43 survived the transplant procedure, and for 100 days or more after transplant. Even though many patients have relapsed leukemia, 36 of the 43 are still living.’
Although the bone marrow division is not capable of keeping up with standards, the Chao Family Comprehensive Cancer Center, under which the marrow program operates, is one of 39 National Cancer Institute-designated comprehensive cancer centers in the nation and is the only one serving Orange County.
According to the OC Register, the marrow transplant program suffered from a lack of full-time staff, similar to the Liver Transplant Program. Leonard Sender, the bone marrow transplant program’s interim director, splits his time with the Children’s Hospital of Orange County where he works as cancer center director.
Unlike most cancer centers certified to perform bone marrow transplants by the Foundation for the Accreditation of Cellular Therapy, UCI’s Chao Family Comprehensive Cancer Center is not. The program is also not part of the donor program registry that connects patients to more than 10 million donors worldwide. UCI does not perform 10 donor transplants a year and therefore does not qualify to be part of the National Marrow Donor Program registry.
Despite the failures, the bone marrow transplant program continued to operate because of the few options for Orange County patients. According to Chief of Hematology/Oncology Randall Holcombe, the patient’s well-being was not jeopardized by the Center’s weaknesses.
‘Even in our lean years, when we did few [transplants] here, we referred patients to other centers to get a bone marrow transplant,’ Holcombe said to the OC Register. ‘Everyone who needed one, got one.’
Frank Meyskens, founder and director of UCI’s cancer center, told the OC Register that more funds are required to strengthen the marrow transplant program. The UCI administration has not provided funding for more than one or two transplant doctors but Meyskens said the center will attempt to form a team of three or four in the coming years.
Susan Mancia, senior public information representative for the UCIMC, declined to answer questions about the Center’s failure to meet state standards.