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As Wait for New Heart Got Longer, Patient Grew Sicker

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Regina Tran holds a photo of her brother, Travis Hogan, who died in 2016 after being removed from the heart transplant waiting list at Baylor St. Luke’s Medical Center in Houston.

In early 2014, when Travis Hogan’s malformed heart was failing, his longtime doctors at Texas Children’s Hospital referred him to Baylor St. Luke’s Medical Center, long recognized as one of the best in the country for complicated heart transplants.

Hogan, then 29 and living at his family’s home in Pasadena, Texas, didn’t know it, but the iconic program was undergoing a series of dramatic changes.

Two years earlier, the transplant program slipped into turmoil when several top physicians left for a competitor. In the years that followed, patients at St. Luke’s waited significantly longer than the regional or national average for new hearts.

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In 2015, as Hogan’s health declined after more than a year on the list, he was dealt two additional blows. First, hospital staff took him off the active transplant waiting list in November 2015, citing his worsening liver as cause for concern, which his mother, Georgeann Hogan, said she did not know until told by a reporter this week.

Then, around that same time, hospital staff explained that Dr. O.H. “Bud” Frazier, the 75-year-old surgeon who initially agreed to treat her son, was no longer operating. Frazier had been planning to implant a ventricular assist device to aid Hogan’s failing heart and allow his liver to recover until he could receive a transplant, Georgeann Hogan said.

She said nobody told her family why Frazier had stopped operating; Frazier told reporters in an interview in April that he was getting old and was ready to stop.

The change stunned Hogan’s family.

They did not realize that earlier in the year, several patients died shortly after receiving transplants at St. Luke’s, leading the hospital to scrutinize the heart program and adopt a more conservative approach.

It also hired a new lead surgeon, Dr. Jeffrey Morgan, who arrived in early 2016. Hospital staff told the Hogans that Morgan would pick up where Frazier left off with his plans for a ventricular assist device, Georgeann Hogan said.

A photo of Hogan on display in his family’s home (Elizabeth Conley/Houston Chronicle)

But after Travis Hogan was admitted to the hospital in February 2016, St. Luke’s Heart Transplant Medical Review Board decided he “would not likely survive a combined heart and liver transplant,” the hospital said in a statement. Morgan sent word via Hogan’s cardiologist that he would not be operating, Hogan’s family said, not even to implant the heart assist device.

“That was devastating,” said Hogan’s sister, Regina Tran.

In past decades, patients born with a heart defect such as Hogan’s came from around the country to be treated at St. Luke’s, which was known for its willingness to take the most difficult cases. But in 2016, according to publicly available data, the hospital did not add a single patient with a congenital heart defect to its transplant waiting list; meanwhile, other high-risk patients, such as Hogan, were removed from the list.

Dr. Andrew Civitello, the transplant program’s top cardiologist, remembered a handful of difficult conversations with critically ill patients that year, though he did not refer specifically to Hogan: “‘We wanted and still want to transplant you,’” he said, recalling how the conversations played out, “’but given the current environment, we unfortunately can’t take the risks.’”

Wait Times

How long it took for 25 percent of patients on the waitlist to receive a heart transplant, between mid-2011 and the end of 2016, for Houston


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