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AGH ready to go on liver transplants

After a year of exhaustive preparations, Allegheny General Hospital's liver transplant program is ready for patients, with seven on its waiting list.

"If a donor became available tonight, we'd be ready to do the transplant," said Mary Ann Palumbi, senior director of transplantation surgery at the North Side hospital.

The program is the region's second adult liver transplant program, along with the University of Pittsburgh Medical Center's world-reowned program.

Its purpose is not to compete with UPMC, but rather to allow long-time Allegheny General patients who need a liver to stay at the hospital instead of having to go elsewhere, officals said.

Patients whose insurance coverage does not allow them to get the surgery locally must travel to out-of-state transplant centers, such as Cleveland Clinic or Johns Hopkins Hospital in Baltimore.

That's an extremely taxing proposition for patients who are accustomed to their doctors and are very sick from their illness, said Dr. Ngoc Thai, and Allegheny General liver transplant surgeon recently recruited from UPMC.

"A liver transplant is one of the scariest experiences for a patient," Thai said. "All of a sudden you've been here and you're used to this area, you're used to the physicians, and you have to pick up and go hours away to another hospital."

That's the case for patients whose coverage is provided by health insurer Health America. Those patients can't get liver transplants locally.

Allegheny General is negotiating a contract with Health America for liver transplantation, said spokesman Tom Chakurda, who characterized negotiations as encouraging and hopeful. Health America officals say they will evaluate Allegheny General's program for consideration.

This is not Allegheny General's first foray into transplantation. The hospital has long-standing programs in heart, kidney and pancreas transplantation. Its busiest is the kidney program, with 95 if the procedures preformed last year, according to the United Network for Organ Sharing.

Chakurda said performing liver transplants is a natural extension of those programs. He said motivation is clinical, not financial.

For example, the liver transplant program would benefit patients of Allegheny General's center for digestive health, the region's seond-largest group of doctors who treat problems of the digestive system, which includes the liver.

Dr. Jose Oliva, a transplant hepatologist at Allegheny General, said his group treats hundreds of patients a year with liver problems, from elevation of liver functions to hepatitis C and cirrhosis. Oliva estimates that 20 to 30 patients a year are referred to other centers to be evaluated for a potential liver transplant.

"We want to keep those patients here," Oliva said. "The patients just don't want to go somewhere where they have no clue where they're going and they don't know the personnel."

Allegheny General has hired four transplant surgeons including Dr. Thomas V. Cacciarelli, a UPMC-trained surgeon who is director of the liver transplant program a the Pittsburgh VA Healthcare System. Cacciarelli, who has performed more than 500 liver transplants, will continue to do transplants at the VA.

Cacciarelli would not say how many liver transplants are projected to be performed at Allegheny General.

Page updated: September 21st, 2007