Jefferson to restart, expand heart transplant program

Jefferson Health announced Friday it plans to resume heart transplants this fall and boost the size of its program after making the unusual move of voluntarily suspending the program for seven months.

Heart transplants are among the most prestigious services a hospital can offer, and sometimes such programs are shut down by regulators due to subpar performance. But that wasn't the case for Jefferson, which chose to put the operation on ice as it embarked on a national search for new leadership.

The health system said cardiologist Andrew J. Boyle, who came to Jefferson in June from the Piedmont Heart Institute in Atlanta, will serve as medical director of advanced heart failure. Surgeon Howard Todd Massey, who comes from the University of Louisville, will join Jefferson as its director of surgical treatment of advanced heart failure.

In February, the health system said the temporary suspension was needed in order to undertake a "significant redesign" and expansion of the program. From 2006 to 2015, surgeons at Thomas Jefferson University Hospital performed 13 heart transplants per year, on average, according to data from the U.S. Department of Health and Human Services.

Rohinton J. Morris, chief of cardiothoracic surgery at Jefferson, said the additions of Massey and Boyle mark the start of a hiring process that will eventually enable the health system to perform three times that many transplants.

"The top programs in the country are those doing about 40 to 50 heart transplants a year," Morris said. "We want to be on that level."

In Philadelphia, the Hospital of the University of Pennsylvania already is doing that many  heart transplants. Other heart-transplant centers in the city are Temple University Hospital, Hahnemann University Hospital, and Children's Hospital of Philadelphia. Under regulations from the Centers for Medicare and Medicaid Services, centers are expected to maintain an average of 10 transplants per year.

The temporary stoppage at Jefferson prompted some surprise in the organ-transplant community when it was announced. Hospitals commonly continue to perform such surgeries even while undergoing expansion, said Jim Gleason, a board member of the United Network for Organ Sharing, the organization that oversees transplants nationally.

Gleason, a Burlington County resident who underwent a heart transplant in 1994 at Penn, said he had called Jefferson to ask about its plans and was encouraged to see the hospital was sticking with the fall reopening.

"They're right on target for whatever their plan is," Gleason said. "It was a good program to begin with. I never really understood why they went into hiatus."

Morris said the expansion will be fueled in part by the addition of "shared-care sites,"  other hospitals that agree to refer their transplant candidates to Jefferson. Two health systems that already can do so are Abington and Aria, both of which merged with the Jefferson health system in the past year.

Jefferson also will seek shared-care arrangements with independent health systems such as Christiana Care in Delaware, Main Line Health, and Geisinger in Danville, Pa., which includes the AtlantiCare system in South Jersey, Morris said.  Patients would be referred to Jefferson for a transplant and then return to the referring hospital for follow-up care, he said.

"This is the vision of Dr. Klasko and the leadership here, that we carry our expertise of care out to the community," Morris said, referring to Jefferson chief executive officer Stephen K. Klasko.

"Being able to have a program that is two, three, four times the size of the average program puts you in a different league," Zuckerman said.

While heart transplants were suspended, Jefferson and Abington have continued to implant ventricular assist devices, artificial pumps that can serve as a "bridge" to help transplant candidates for whom no donor organ is immediately available.

Increasingly, some hospitals also have been implanting these devices as "destination" therapy, meaning they are intended for patients who are not healthy enough to be transplant candidates. Morris said about half of the patients getting the devices at Jefferson meet that definition, and more than half are in that category at Abington.