October 25, 2006
The Michael E. DeBakey VA Medical Center joins four other VA medical facilities offering liver transplantation to veterans as an appropriate therapy for end-stage liver disease. Above, David H. Berger, M.D., Operative Care Line executive (right) performs surgery with David Chafey, M.D., resident (left) and Kostas Votanopoulos, M.D., chief resident.
HOUSTON – In August 2006, the Michael E. DeBakey VA Medical Center (MEDVAMC) received official designation as a Liver Transplant Center from the Department of Veterans Affairs (VA). The MEDVAMC joins Portland, Oregon; Nashville, Tennessee; Pittsburgh, Pennsylvania; and Richmond, Virginia VA Medical Centers offering liver transplantation to veterans as an appropriate therapy for end-stage liver disease.
The VA National Transplant Program began providing solid organ transplants to veteran patients in 1961. Thomas E. Starzl, M.D. performed the VA’s first kidney transplant at the VA Medical Center in Denver. Since then, the VA National Transplant Program has expanded services to provide veteran patients with heart transplant services in 1980, bone marrow in 1982, liver in 1989, and lung in 1991. Most transplants are performed in-house in specific VA medical centers across the country. VA also utilizes several VA sharing agreements with university affiliates and local emergency contracts for critical cases.
Partnering with John A. Goss, M.D., chief, Division of Abdominal Transplantation at Baylor College of Medicine and the program director of the liver transplant programs at St. Luke’s Episcopal Hospital, The Methodist Hospital, and Texas Children’s Hospital, the goal of the new MEDVAMC Liver Transplant Center is to provide the same high level of care to the veteran population. Goss’ program is one of most successful liver transplant programs in the United States with a 93 percent survival rate at the one year mark and 90 percent at the three year mark. The national average is 85 percent survival rate at the one year mark and 80 percent at the three year mark.
“One of the key reasons the Michael E. DeBakey VA Medical Center was selected to become a Liver Transplant Center is our outstanding surgery program. This past April, the National Veterans Affairs Surgical Quality Improvement Program Executive Committee recognized our consistently low observed-to-expected mortality rates in general surgery, all surgery, and all non-cardiac surgery six years in a row. The MEDVAMC is the only VA facility with this record,” said Edgar L. Tucker, MEDVAMC director.
In 1995, a national VA transplant office was established in Washington, DC. to ensure all veterans received equal access to transplant services and establish a central referral center. A computerized database was developed and currently, there are over 12,000 transplant records maintained in the national VA transplant database dating back to 1995.
The VA National Transplant Program office receives approximately 1,200 referrals per year. Approximately 350 transplants are performed annually. The number of transplants performed has remained consistent since 1994.
“Currently, we are training and hiring staff, analyzing patient data for transplant suitability, and putting medical processes in place. We believe we will perform our first liver transplant next spring or early summer. Once our program matures, we estimate the Liver Transplant Center at the Houston VA will perform 40 to 60 transplants a year, limited most likely only by the availability of organs,” said David H. Berger, M.D., MEDVAMC Operative Care Line executive.
Liver transplant candidates must undergo detailed physical, laboratory and psychological evaluations to ensure proper selection and therapy. Tests are done to confirm the diagnosis of end-stage liver disease, to rule out other potential treatments, and to assess the candidate’s ability to tolerate surgery.