Here's a new twist on crosstown rivalry among Chicago-area hospitals: They're aggressively bulking up their organ transplant programs and poaching prominent specialists from local and national competitors to pull it off. Demand is up, but there's another reason for Illinois' surge: more available organs. It's an unintended consequence of the opioid epidemic—people who die of overdoses have become a new source of organs.
It takes only a quick glimpse at the numbers to understand the demand. Nationwide, in 2016, transplants hit a record high of nearly 34,000. That year, nine Illinois hospitals performed a collective 1,208 transplants, a 23 percent jump from 2015 and the most since 2009.
"Even though there's a record number of transplants this year, it doesn't come close to meeting the need," says Dr. David Klassen, chief medical officer of United Network for Organ Sharing, or UNOS, a Richmond, Va., nonprofit that manages the national organ transplant system. While the number of people waiting for kidneys, livers and lungs, for example, dipped for the second year in a row, the national waitlist still totals nearly 120,000. In Illinois, about 4,700 people are waiting for transplants.
Besides long waitlists, there are also fewer organs leaving the state, unlike in previous years when hospitals here shunned some available parts fearing subpar patient outcomes. While the industry is still heavily regulated, the federal government has applied less scrutiny recently to patient and organ survival rates. That has prompted hospitals to consider organs they might have otherwise rejected.
"Programs are less concerned," says Kevin Cmunt, CEO of Gift of Hope Organ & Tissue Donor Network, an Itasca nonprofit organ donation advocacy group. "They can be a little bit more aggressive."
Transplants are one of the most resource-intensive services hospitals provide, and the procedures are not necessarily a big moneymaker, says Pamela Damsky, a New York-based director at health care consultancy Chartis Group. Milliman, a Seattle-based actuarial firm, estimates that the average total cost for a heart transplant in 2017 will reach $1.38 million. That's not just for the surgery. It includes lengthy doctor visits before and after surgery and anti-rejection drugs that patients must take for life.
Still, having a transplant program brings cachet and prestige to a health system. Maywood-based Loyola University Medical Center, which performed 246 transplants last year, spends up to $40 million annually to maintain its program, which grew 64 percent from 2015 to 2016. The academic medical center nearly tripled its kidney transplants during that period, totaling 106. Kidneys are, by far, the most in-demand organ and are among the hardest to get. About 40 percent of people on the kidney waitlist in Illinois have been there for at least three years.
Among those waiting for a kidney is Chicago Police Superintendent Eddie Johnson, who has put a public face to the plight. He is expected to underscore the importance of organ donation at a summit Feb. 21 organized by Gift of Hope and government agencies, including Mayor Rahm Emanuel's office.