A heart transplant program too good to be true.

The Albany (N.Y.) Times-Union has an article in today's paper about Albany Med's three-year-old heart-transplant program. Seems it has outcomes far better than many more established transplant centers at more vaunted institutions. That may be because its recipients were healthier than the transplant surgeons were letting on. By exaggerating the acuity of their patients' illness, the surgeons were leapfrogging sick patients on the transplant list and simultaneously skewing their statistics by putting hearts in healthier patients who could be expected to have better recoveries. What they did is, of course, a violation of the rules established by the United Network for Organ Sharing (UNOS), which administers this country's transplant program under contract with the Department of Health and Human Services (DHHS). The Division of Transplantation of DHHS' Health Resources and Services Administration in turn oversees implementation of the National Organ Transplant Act through its organ-transplantation regulation. UNOS' audit of Albany Med's statistics turned up "discrepancies" that led Albany Med to suspend operation of the transplant center and the two surgeons who run it (see Albany Med's press release). Violations of UNOS protocols are enormously unfair to patients who were in line for a new heart but lost out to patients beneath them on the list. Rank manipulation of the rules of the game also undermines the public's confidence in the whole process. Logically, it's not a stretch to imagine that lessening of confidence in the fairness of the system could have an impact on the willingness of families to designate brain-dead loved ones as organ donors. Bad (and sad) news.