There is a crisis in health care in Hawaii for cancer patients. Sadly, the closure of Hawaii Medical Center (HMC) created a critical hole in health care in Hawaii.
Many people are not aware that there were two transplant programs at HMC: One was for solid organ (liver and kidney), and the other was for bone marrow for cancers (leukemia, lymphoma and myeloma).
Thus far, only the solid organ transplant program is being saved.
Since Dr. Livingston Wong pioneered the first bone marrow transplant in 1978, more than 250 men, women and children have gotten a second chance at life.
Bone marrow or blood stem cell transplants were performed at the HMC. Pediatric transplants are performed at the Kapiolani Medical Center for Women and Children; Hawaii Pacific Health has committed to continue it in the future. However, the adult bone marrow program has nowhere else to go.
There are multiple parts to the bone marrow transplant program that also need to be saved. The Hawaii Bone Marrow Donor Registry, operating since 1989, has worked up more than 3,111 preliminary matches, 331 of which have gone on to donate bone marrow or stem cells. The registry coordinated 217 bone marrow and 114 stem cell collections from unrelated donors. In addition, the Tissue Typing HLA (human leukocyte antigen) lab is essential for both the solid organ and bone marrow transplant programs. This essential lab represents a shared resource for our community and deserves community support.
Finally, unrelated donor stem cell or bone marrow collections were previously done at HMC. These collections helped people outside of Hawaii; our bone marrow transplant program helps those in Hawaii.
Many residents of Hawaii can’t afford to travel to the mainland, get a transplant and stay afterward for post-transplant follow-up. Even with discounts, the housing cost for one person can exceed $6,000 for three months. The American Cancer Society is helping, but private organizations can’t solve all of the problems. Of the 11 patients on the bone marrow transplant list before HMC abruptly closed in December, six have been urgently referred to transplant centers on the West Coast. When someone has leukemia and needs a transplant, time is of the essence.
The state of Hawaii would save money by supporting both the solid organ and bone marrow transplant programs rather than sending patients to the mainland. When a patient travels to another medical center, many of the lab tests, X-rays and CT scans are unnecessarily repeated. Often there are costs in addition to medical care that the Medicaid programs have to pay, such as travel, housing and meals. In this case, the state would save more than $500,000 a year by keeping the adult bone marrow transplant program alive in Hawaii.
Currently, transplantation offers the light of hope in the darkness of fear. For many adults and children, bone marrow transplantation represents a last chance. Over the past 10 years, the bone marrow transplant program has shown overall results that are as good as or better than national averages. It would be impossible to rebuild these programs if the skilled personnel are lost to the mainland. These are programs in Hawaii worth saving. The state Legislature needs to support both of the transplant programs.