Good-Hearted Intentions


The city is on the verge of having two competing heart-transplant programs.



 

Surgeons have been performing human-to-human heart transplants since 1967, but the procedure hasn’t yet reached Central Florida. So far, local patients who have needed a new heart have had to travel elsewhere, often to Tampa or Gainesville.

That will be changing soon, following a ruling in August by the state’s Agency for Health Care Administration. In that ruling, the agency gave approval to both Florida Hospital and Orlando Health to create heart-transplant programs. (At the same time, the agency approved lung transplants at the former.)

Most likely, then, sometime this year Orlando will become the only city in Florida with two competing programs for transplanting hearts.

Florida Hospital estimates that its program will be up and running by summer. Meanwhile, Orlando Health plans to have its program operational this spring, with Dr. Javier Lafuente at its helm. Lafuente moved to the Orlando area in July, after spending the past 23 years in Houston, where he worked at the Methodist DeBakey Heart & Vascular Center. (That was the home base of Dr. Michael DeBakey, the famous heart-transplant pioneer who passed away last year.)

For Lafuente, “the nicest part” about being involved in the Orlando Health program is the chance it offers him “to be able to start something from the ground up” and “design it the right way.”

 For Beth Boyer Kollas, that new program represents a natural progression.

“There was just this gap in the services,” says Boyer Kollas, administrator for business development/strategy for Orlando Regional Medical Center and Lucerne Hospital, both part of Orlando Health. “If we were going to say, ‘We want to provide comprehensive cardiac care,’ this is what we need to do.”

Beth Weagraff, senior vice president of Florida Hospital Orlando, offers a similar take on her organization’s plans. “This is the last component . . . that makes up a comprehensive cardiovascular program,” she explains.

Having even one heart transplant program in town would clearly be a boon.

“Imagine, if you will, that you or I are diagnosed, and we have to leave our home, our family, everything that is dear to us,” says Weagraff, referring to the current situation for local heart-transplant patients. Boyer Kollas notes that a heart-transplant program in Orlando would spare patients the burden, “financially, emotionally, psychosocially,” that traveling to another city for surgery—even a city as close as Tampa—now imposes.
In theory, having two such programs in town can only be a good thing. In practice, the situation is more complicated.

In order to qualify for Medicare payments for heart transplants, a hospital must perform at least 10 of them per year. In addition, Weagraff points out, it’s important for surgeons to perform these procedures regularly to keep up their skills.

Will there be enough business to go around?

“I think the numbers in the long haul will bear out whether our community can support both programs,” says Weagraff. She adds that Florida Hospital hopes to be performing 18 heart transplants by its second year and 28 within five years. (Her projection for lung transplants is 15 in the second year and 24 within five years.)
Boyer Kollas estimates that by the second year, the Orlando Health number for heart transplants will be between 12 and 20.  Lafuente says he eventually hopes to increase its annual heart-transplant number to about 30.

According to Eric Stevens, vice president of surgery transplant in ambulatory services for Florida Hospital, his organization hopes to select a surgeon to lead its heart-and-lung transplant program by this month.
“We need someone who can engage our local medical community,” he says. “We need someone who can pull that existing talent together into a team.”

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