Transplant center bill could get green light next month

Lawmakers might fast-track a bill that would authorize state money to help the Queen’s Medical Center establish an organ transplant hub after the only facility in the Pacific closed in the Hawaii Medical Center’s bankruptcy.

The bill would offer state money that could be matched by Queen’s or other private sources to support kidney and liver transplants. Lawmakers, fearful that the Transplant Institute of the Pacific at Hawaii Medical Center’s Liliha hospital might close because of HMC’s financial difficulties, were close to an agreement on the bill in April. But the bill was one of dozens of casualties in the brinkmanship between the state House and Senate over tax policy at the end of last session.

The Legislature may act on the transplant center bill shortly after the next session opens in January. Advisers to Gov. Neil Abercrombie said the governor would consider an emergency appropriation.

More than 400 patients in Hawaii are awaiting kidney, liver, pancreas, pediatric kidney and bone marrow transplants. Patients who need immediate transplants are being sent to the mainland for care.

The Transplant Institute of the Pacific was shut down this month as the Hawaii Medical Center, in bankruptcy and unable to secure terms with a buyer, closed its hospitals in Liliha and Ewa.

Queen’s will apply with the United Network for Organ Sharing — a private nonprofit that manages the national transplant system for the federal government — to obtain the certification necessary for an organ transplant center, a process that could take several months.

"In order to save it for Hawaii and prevent families to have to travel for such a long period of time to the mainland, we felt that this was a good investment of state dollars," said state Rep. Ryan Yamane (D, Waipahu-Mililani), chairman of the House Health Committee, who has been working on the legislation with transplant interests for more than a year.

Yamane said lawmakers had planned to offer $1.5 million in state money for a transplant center if private sources matched the state money dollar for dollar, with the understanding that it would take about $3 million to get a facility in operation. He said the details of the legislation would be reviewed when talks between House and Senate negotiators resume next session.

Queen’s could not immediately estimate the total operating cost of establishing and maintaining a new transplant center, but hospital executives believe, based on the experience at Hawaii Medical Center East in Liliha, that the facility could lead to losses of $7 million to $8 million in the first five years.

"We are grateful for any financial support we may receive from the state of Hawaii," Art Ushijima, president and chief executive officer at the Queen’s Health Systems, said in an email.

The organ transplantation program, he said, "is a major and unique community asset and the only program of its kind in the state. Without it, hundreds of Hawaii residents will need to seek this service on the mainland."

The National Kidney Foundation of Hawaii and several transplant patients, including then-House Chief Clerk Patricia Mau-Shimizu, asked lawmakers last spring to preserve transplant services in Hawaii.

Mau-Shimizu, who had severe chronic kidney disease and received a transplant at Hawaii Medical Center East in Liliha in 2009, described it as a long and stressful process that can take years from diagnosis to surgery and recovery.

She told lawmakers that patients, who often need their families and support networks to recover, should not have to travel to the mainland.

CJ Leong, a legislative staffer who was Mau-Shimizu’s kidney donor — and has since succeeded her as House chief clerk — told lawmakers she did not know whether she would have gone through with the surgery and the lengthy recovery if she had been required to go to the mainland.

Most patients on the transplant waiting list in Hawaii have kidney disease. In addition to preserving an organ transplant center in the islands, lawmakers also want to sustain a chronic kidney disease management program to stress healthier lifestyles and disease prevention.

Mau-Shimizu’s and Leong’s kidney transplant ordeal was well-known at the state Capitol, a personal example that brought the potential closing of the transplant center closer to home for many lawmakers and staff.

Similar versions of the transplant center bill passed unanimously in the House in March and in the Senate in April. Lawmakers met in conference committee on the bill and scheduled talks on the deadline day in late April to have legislation ready for final votes before the session adjourned in early May.

But House and Senate leaders took negotiations on tax policy to the brink, holding up action on other bills, including several they might have otherwise passed and sent to the governor.

House and Senate leaders are now looking at nine bills — including the transplant center bill — to fast-track in January.

"I’m just really glad that the bill is available to do exactly what it is in the position to do now," said Glen Hayashida, chief executive officer of the National Kidney Foundation of Hawaii.

State Sen. Josh Green (D, Milolii-Waimea), chairman of the Senate Health Committee and an emergency room doctor, said a transplant center is an essential service that Hawaii should not lose for long.

He said it would be disruptive, even disastrous, for patients to have to rely on care on the mainland.

While Green and others wanted to pass the bill last session, he credited House and Senate leaders for making it a priority now.

"Stuff happens in politics," he said, "even things that are not political, like health care."