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261 people received a liver transplant at UPMC between July 2008 and December 2010. Of those patients, 42 died. Nation-wide averages indicate fewer than 29 where expected to die. But, Christopher Hughes, UPMC's surgical director for liver transplants, said that's not due to negligence on the hospital's part, but rather to deficiencies in the way transplants are reported.
"If there's one thing I can criticize our program about, it's our self-reporting of data," said Hughes.
He said data reported to the Scientific Registry of Transplant Recipients often doesn't reflect how sick patients really are. He pointed to one case in which a woman had to undergo heart surgery and a liver transplant, but in the data the severity of her illness and risk level weren't reported.
"Transplant centers that are very aggressive in this country are getting penalized because the severity of illness of our patients is not risk-adjusted enough to compensate for the risk that we're taking trying to save them," Hughes said.
But, he said, that is expected to change. Next week, Hughes will travel to Washington, DC where he'll be part of a discussion on risk adjustment. He said the United Network for Organ Sharing is starting to recognize that the measurement of severity of illness in patients is lacking. Hughes will join transplant center personnel from around the country for the three-day meeting.
Aside from changing reporting practices, Hughes said there are no plans to change other aspects of the liver transplant program, which he added is one of the most aggressive in the nation.
"I think we need to continue to maintain our heritage and not turn away people because we think they're a challenge just to protect data," he said.
Hughes said in the last 6 months no UPMC patients have died after having a liver transplant.
