UPMC Montefiore will undergo a review of its living-donor kidney program that could take months before it can be restarted, the hospital and federal officials said Tuesday.
The hospital system would not say what the problem was that prompted it to shut down it on Monday, except to say in a statement that it did "not involve a donor or recipient death."
But taking such an action is rare, experts said, occurring perhaps once or twice a year among the nation's 250 transplant centers. And most of those shutdowns are typically at smaller hospitals that lost their transplant surgeon or administrator -- something that is not an issue in a transplant center as large or prominent as UPMC Montefiore, where adult transplants are done.
"You wouldn't close down for a minor problem," said William Harmon, director of the kidney transplant program at Children's Hospital of Boston and a former board member of the United Network for Organ Sharing, an agency that oversees the nation's transplant programs. "This is probably much more than a minor problem."
UPMC notified the Centers for Medicare and Medicaid Services (CMS) late Monday that it was voluntarily stopping the program, CMS spokeswoman Lorraine Ryan said in a statement.
CMS is currently reviewing UPMC's entire transplant program, though Ms. Ryan would not say if the review is what led to the shutdown of the living donor kidney program.
But Dr. Harmon said it probably wasn't a coincidence that the shutdown occurred now.
"CMS's reviews are surprise visits," he said, "and it probably uncovered something that stimulated Pittsburgh [UPMC] to voluntarily shut down."
UPMC did not address CMS's review in its statement.
"We have voluntarily postponed currently scheduled living donor kidney cases until UNOS can complete a review of an issue we discovered and reported to UNOS," the hospital's statement said. "We fully anticipate a resumption of cases in the very near term. We strive for excellence in our clinical care with the well-being of patients as our highest priority."
The shutdown does not affect the deceased donor kidney transplant program -- which made up 90 of the 152 adult kidney transplants UPMC did last year -- or transplants affecting children at Children's Hospital of Pittsburgh of UPMC.
UNOS spokesman Joel Newman said he could not say why UPMC shut down its program -- which UNOS refers to as "inactivations" -- except to note that hospitals shut their programs down for a variety of reasons, including staff changes, administration changes, as well as patient safety issues and problems with labeling and packaging organs for transport, or issues with donor disease transmission.
A spokesman for the Center for Organ Recovery and Education, the federally recognized local agency that oversees organ procurement for hospitals in the region, also would not comment about why UPMC shut down its program, referring questions to UPMC.
Mr. Newman said UNOS would not say how many other hospitals have voluntarily shut down their programs in recent years "because inactivations can occur for many reasons and for different lengths of time, we're concerned that any number or any time frame doesn't provide meaningful context."
Dr. Harmon and other transplant experts said that such shutdowns are rare, occurring perhaps once or twice a year.
But having a large, prominent program like UPMC's shut down where there are not staffing issues "is even rarer," Dr. Harmon said.
UPMC's living donor kidney transplant program made headlines in March, when it took part in one of the largest-ever chain kidney donations, whereby 32 people exchanged kidneys, resulting in 16 people getting new kidneys.
That chain was organized by the National Kidney Registry in Babylon, N.Y., a private organization that now works with nearly 60 transplant centers trying to build larger and larger chains of living kidney donations.
Garet Hil, founder and president of the National Kidney Registry, said Tuesday he had only just learned about UPMC's decision to temporarily shut down its program and he was "waiting for a call back" to explain the problem.
"From what I saw it didn't seem like it was anything major, but there has to be a reason," he said. "But I'm still surprised that you [the media] don't know at this point what's going on. If it's just an administrative thing, you'd think they'd want to be open about it."
But Dr. Harmon said that when problems like this are found, it is typically kept confidential until a full peer review of the problem and how it will be corrected, is completed, which could take weeks if it is expedited, but often takes months.
"The goal is to correct the problem, not punish the program," he said.
Correction/Clarification: (Published May 12, 2011) UPMC Montefiore is the hospital where a living kidney donor program is undergoing a review by hospital and federal officials. An incorrect hospital was named in a story Wednesday about the program being shut down.
First Published: May 11, 2011, 4:00 a.m.
