Ambulance service in Leeward Oahu has been beefed up in response to the announced closures of Hawaii Medical Center East and West, Mayor Peter Carlisle said Saturday.

However, no solution has yet been found to the imminent loss of the state’s only transplant facility.

The city Emergency Medical Services Division already had ambulance units in Waianae, Makakilo and Waipahu and a unit in Nanakuli on duty 16 hours a day.

To increase the emergency response capabilities for the Leeward Coast, Carlisle said, two additional EMS ambulance units were placed in service and the existing unit at Nanakuli has been expanded to 24-hour coverage.

The Hawaii Medical Center notified the city Friday that neither of its hospitals would accept any patients by ambulance and could close their emergency rooms within days. Hawaii Medical Center West, in Ewa, is the closest major hospital to the Waianae Coast.

A statement from the city said Carlisle and the Emergency Services Department "continue to closely monitor the consequences of the announced closures of the Hawaii Medical Center East and West."

EMS ambulance units from Leeward and Central Oahu had been using Wahiawa General Hospital and Pali Momi Medical Center in Aiea since Friday afternoon. However, those hospitals had maximized their capacity by Saturday afternoon, prompting ambulances to redirect patients to Kaiser Moanalua Medical Center, Tripler Army Medical Center, the Queen’s Medical Center and Straub Clinic & Hospital.

EMS received more than 40 calls for emergencies from the Leeward Coast from midnight to noon on Saturday, the city said.

Don Olden, chief executive officer of Wahiawa General Hospital, said his facility diverted ambulances from 11 a.m. until 4 p.m. on Saturday.

"But that isn’t unusual," Olden said. "We were busy but not abnormally busy. We’re a key emergency service node in our area and we try as much as possible not to divert. It wasn’t a problem of not having enough hospital space; we were simply swamped in the emergency room."

Olden said the city’s move to expand ambulance service on the Leeward side would be "helpful" but added that while Wahiawa, Pali Momi and other facilties would be able to accommodate more ambulance traffic, the real difficulty could come from an increase in walk-in patients once HMC West closes.

"If they get 70 patients a day and 20 of them are brought in by ambulance, that leaves 50 that are walk-ins," Olden said. "That will saturate us like mad. We average 50 (emergency patients) a day. Sixty would be really stretching us."

Pali Momi spokesperson Shawn Nakamoto said the current situation has put additional pressure on emergency services personnel to triage carefully.

The facility’s emergency room reached capacity on Saturday and was able to accommodate only critical emergencies, Nakamoto said.

However, Nakamoto said, it was not clear whether rerouted service from HMC West contributed to the rush.

"We’re the second-busiest ER after Queen’s," she said. "Busy is normal for us."

Of potentially greater concern is the closure of HMC East in Liliha, the state’s only transplant facility.

Glen Hayashida, chief executive officer of the National Kidney Foundation of Hawaii, said that 60 to 70 people undergo transplants in Hawaii every year. In all, more than 420 people in Hawaii are on the organ donor waiting list, all but about 30 in need of a new kidney.

With the facility winding down operations — HMC no longer has an active administrator, according to an HMC operator — those patients will have to go to the mainland to receive lifesaving transplants.

"Our concern is that these people are going to have to be away from family — isolated," Hayashida said.

Hayashida said he has spoken with lawmakers and hospital administrators in hopes that one of the existing hospitals will agree to become a transplant center.

Acknowledging that such a move would involve a significant commitment of resources and a several levels of evaluation and approval, Hayashida said it could take anywhere from three months to a year for a new center to get up and running.