UPMC transplant chief resigns under pressure

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Dr. Amadeo Marcos resigned yesterday as the University of Pittsburgh Medical Center's transplantation chief after being placed on leave for violating UPMC's code-of-conduct policy, according to a source familiar with the situation.

UPMC set these events in motion last Thursday when Dr. Timothy Billiar, the chairman of surgery at the University of Pittsburgh School of Medicine, called the 46-year-old Dr. Marcos into his office and informed him of UPMC's decision to put him on administrative and clinical leave.

Dr. Billiar also presented him with a choice -- resign or be fired. Dr. Marcos had the weekend to think about it, and he submitted his resignation yesterday.

It is not yet known how Dr. Marcos violated UPMC's conduct policy or why he left. UPMC spokeswoman Maureen McGaffin would only confirm that Dr. Marcos had resigned. She would not elaborate on the reasons or circumstances surrounding his departure, saying in an e-mail that "you'll have to discuss that with Dr. Marcos."

Dr. Marcos could not be reached for comment.

Last night at Dr. Marcos' home in Fox Chapel, his wife answered the door, said her husband was not home and she did not know when he would be available or if he would be available to talk.

Known for his expertise in living liver transplantation, Dr. Marcos replaced Dr. John Fung as transplantation chief in 2004 after Dr. Fung left for the Cleveland Clinic.

But his strong personality and behavior did not always play well inside UPMC's transplantation unit, according to a source close to the situation, as Dr. Marcos was known to react belligerently in certain situations. That may have alienated colleagues and contributed to a lack of support within the UPMC system, this source said.

Also, he and UPMC transplant pioneer Dr. Thomas Starzl were known to have disagreed about certain issues, the source said, including the weaning of transplant recipients off immunosuppressive drugs. Dr. Marcos, in addition to being chief of the division of transplantation, was clinical director of the UPMC Thomas E. Starzl Transplantation Institute.

Dr. Starzl also could not be reached for comment yesterday and no one answered the door at his home last night.

This is not the first controversial hospital stint for Dr. Marcos, who joined UPMC in August 2002 as clinical director of transplantation after serving two years as director of the solid organ transplant program at the University of Rochester.

In 2004, the New York Health Department fined the University of Rochester-owned Strong Memorial Hospital $20,000 for problems in its liver transplant unit, some of which occurred during Dr. Marcos' tenure. Investigators found quality problems with the care of eight of 29 liver transplant patients who received care at Strong Memorial between 2000 and 2003.

The investigators also found several problems with the hospital's use of livers from "expanded-criteria donors," which typically come from older donors or donors with health problems that might have disqualified them in the past.

Before Rochester, Dr. Marcos had a short stay at Beth Israel Deaconess Medical Center in Boston, as a key member of the liver transplant team there. He left after just a month. According to one newspaper report, he was let go over contractual issues.

He also spent four years at the Medical College of Virginia, housed at Virginia Commonwealth University.

At UPMC, Dr. Marcos' use of more marginal organs enabled the hospital in 2002 to reverse a 12-year decline in the volume of liver transplants here. But it generated controversy, too. A dispute between the VA Pittsburgh Healthcare System and UPMC about allocating organs from older or sicker donors led the VA to sever its ties to the UPMC program.

At the same time, some within the transplantation unit grew unhappy with his unpredictable management style and tendency to lose his temper while angry, said a source close to the situation.

A check of Allegheny County criminal and civil court records found that Dr. Marcos was charged June 23 with a count of simple assault, but the charge was withdrawn July 19. Court records available online do not say who filed the charge, why it was withdrawn or the circumstances of the arrest.

There was no indication yesterday that those events had anything to do with yesterday's resignation.

Dr. Marcos also lost his driving privileges for a day last year following receipt of a series of speeding tickets. In one instance, in November 2006, state police charged him with driving 36 mph over the speed limit on the Pennsylvania Turnpike in Westmoreland County.


David Templeton and Michael A. Fuoco contributed to this report. Dan Fitzpatrick can be reached at dfitzpatrick@post-gazette.com or 412-263-1752.


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