USC Hospital halts kidney transplants after error

USC University Hospital released a statement Thursday announcing that it had placed a temporary hold on its kidney transplant program as the result of a “process error.”

The hospital was not free to comment on the nature of the error, but a spokesman for OneLegacy, a program that coordinates organ transplants in Los Angeles, told the Los Angeles Times that a kidney was accidentally transplanted into the wrong patient when two organs from separate donors arrived at the hospital around the same time Jan. 29.

The hospital said “as patient safety is the hospital’s number one concern, the hospital inactivated the program while clinical protocols are assessed and additional safeguards to the kidney transplant program are developed.”

Bryan Stewart, the spokesman for OneLegacy, told the Times the wrongly transplanted kidney was a close enough match to avoid harm for the patient who received it.

“Our packaging and documentation was accurate,” Chief Executive of OneLegacy Thomas Mone told the Times.

He said the mistake was likely the result of “human error” at the hospital.

The hospital voluntarily conducted a review of the kidney transplant program at its own expense, which included “validation of a corrective action plan by a kidney transplant surgeon and transplant administrator from other transplant centers” in addition to staff from the United Network for Organ Sharing Department of Quality, according to the official statement.

According to the hospital, the internal review could be completed as soon as today, at which point hospital administrators will consider resuming transplants because of the high demand for organs.

The hospital notified UNOS, a U.S. Department of Health and Human Services program that organizes the distribution of organs for transplant, of the incident Feb. 4.

The UNOS review will require the hospital to submit a corrective action plan to be approved by the agency to ensure the mistake is not repeated.

A spokesman for the California Department of Public Health told the Times that the licensing agency is also investigating the incident at the hospital. The department is in charge of licensing hospitals in California as well as responding to complaints and reporting incidents regarding those hospitals.

The kidney transplant program at the USC University Hospital has performed more than 250 transplants since its first operation in 1991. The program has a 92 percent patient survival rate and 87 percent graft survival rate at three years post-transplant.