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Accession Number PB2013-100677
Title Healthcare Inspection Liver Transplant Denial Veterans Health Administration.
Publication Date Jun 2012
Media Count 20p
Personal Author N/A
Abstract VA's Office of Inspector General was requested by Congressman John Kline to review why a veteran patient was 'unable to receive a (liver) transplant through the VA system.' We found that the patient in question had chronic hepatitis C as well as serious comorbidities, including coronary artery disease that was treated in 2003 with placement of a coronary artery stent (a device inserted into a coronary artery to help keep it patent (open)). Despite medical therapies, the patient's hepatitis C progressed inexorably. By 2011, it was clear that absent a remission or a liver transplant the patient's hepatitis C was progressive and would almost certainly soon be fatal. Minneapolis VAHCS embarked upon the process of having the patient evaluated for a liver transplant. We found that, as alleged, the patient was indeed 'unsuccessful in obtaining approval for a VA transplant.' Two VA Transplant Centers (VATCs), Houston and Pittsburgh, reviewed the patient's case and did not accept the patient as a candidate for further evaluation. On appeal, Portland VATC also reviewed the patient's case, and also did not accept the patient as a candidate for further evaluation. Ultimately, in August 2011, the patient had a deceased donor orthotopic liver transplant at the University of Minnesota Medical Center. We found that each of the three reviewing VATC's independently provided a decision based upon the clinical data presented and in a manner consistent with VHA policy. Nevertheless, we found and were concerned that Portland VATC, the reviewing VATC on appeal, lists the presence of a cardiac stent as one of five 'absolute contraindications to liver transplantation.' Two other VATCs, Nashville and Richmond, consider patients with cardiac stents for liver transplantation.
Keywords Allegations
Clinical medicine
Health care management
Infectious diseases
Medical services
Office of Inspector General(OIG)
Patient evaluation
Veterans Health Administration
Veterans(Military personnel)

Source Agency Department of Veterans Affairs
NTIS Subject Category 44D - Health Care Assessment & Quality Assurance
57E - Clinical Medicine
57X - Surgery
74 - Military Sciences
Corporate Author Department of Veterans Affairs, Washington, DC. Office of Inspector General.
Document Type Technical report
Title Note N/A
NTIS Issue Number 1306
Contract Number N/A

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