V.A. defends controversial transplant policies

For the first time, the head of surgery at the Department of Veteran Affairs responded to a series of 11Alive investigations, which exposed flaws within its organ transplant program.

Since the investigations aired in August, the 11Alive Investigators has also learned more than a dozen veterans in the transplant program may now receive local transplants if funding is approved. The move comes after the 11Alive Investigators uncovered veterans complaining about traveling thousands of miles for treatment and transplants, putting them in danger.

PART 1 | Distance, Delays, and Denial: VA's broken transplant system
PART 2 | VA denies veteran's perfect kidney match

That includes veterans like, Aaron Arch, an army veteran in San Antonio, Texas.

Earlier this year, the VA told Arch he’ll soon have to travel 1,200 miles to Madison, Wisconsin for a lung transplant, instead of going through a local transplant facility.

“If something doesn’t go as well as hoped that would be where my story would end. It’s a long way from home,” said Arch.

A 2014 study by the University of Pennsylvania found veterans waiting for liver transplants, who traveled 100 miles for treatment, had a “lower likelihood of receiving a transplant and increased mortality.” The VA runs 13 transplant centers across the country. Each facility performs different types of transplants.

William Gunnar is the VA’s National Director of Surgery. He’s a trained heart surgeon and licensed attorney.

In a new study the agency has not released yet, Gunnar claims the VA found requiring veterans to travel long distances doesn’t increase a veteran’s risk of death.

“Regardless of where you live, across the street or 500 miles away, there was no difference in the time difference to transplant,” said Gunnar.

Gunnar says it will likely take several months to release the findings of the new study.

The VA administrator also says only about one in ten veterans in need of transplants would benefit if the agency paid to have a local facility perform the operation. He believes it doesn’t make sense for veterans to go outside the VA because most transplant recipients almost always travel long distances for transplant, in and out of the VA network.

The 11Alive Investigators also uncovered veterans denied transplants for unclear reasons.

That includes Charles Nelson, a Texas army veteran who went through basic training in Fort Benning Georgia. This past June, his son offered to donate his kidney to save his father’s life, but two days before surgery, the VA said it couldn’t pay for the transplant because Nelson’s son isn’t a veteran himself.

“The VA never did anything for us,” said Nelson. “It was just unbelievable is what it was.”

EXTENDED WEB CONTENT | Q & A with VA Dir. of Surgery

Nelson eventually received a transplant at a non-VA facility. In response to his denial, lawmakers filed proposed legislation this summer that could force the agency to pay for similar transplants.

But, that legislation may not be needed. According to Gunnar, the VA already has policies in place allowing the VA to pay for transplants involving donors who are not veterans.

Gunnar doesn’t believe anyone at the VA dropped the ball with Nelson’s case. “Not [in] my opinion,” said Gunnar. “I have knowledge about the sequence of events were there. I can tell you in good faith, the VA made every attempt to purchase that care for that individual.”

Nelson is furious with Gunnar’s response. “To say I’m upset is an understatement. What Dr. Gunnar said is simply not true,” wrote Nelson in an email after reading Gunnar’s response.

“I didn't have a choice. They wanted me to stay in the VA system (Nashville or Oregon) or they wouldn't pay for the transplant. Only after I brought this to media’s attention did the VA ‘offer’ to pay less than 24 hours before the transplant,” Nelson said.

Jamie McBride says that’s not true. He’s a VA transplant program manager in Texas and oversaw Nelson’s transplant.

In an interview with the 11Alive Investigators in August, McBride says the VA routinely denies veterans transplants for unclear reasons.

He also believes the VA should pay local hospitals to perform transplants, instead of forcing veterans to travel thousands of miles away.

“I know that may be detrimental to the national transplant programs in the VA, but it’s what’s best for our patients. It’s the right thing to do,” said McBride.

McBride says Dr. Gunnar, nor anyone on his staff, reached out to him about his concerns.

“I have not personally reached out to him. Quite honestly, he has a whistleblower claim against the organization that has been filed with the Office of Special Counsel that has been assigned for investigation and that investigation is ongoing,” said Gunnar.

While Gunnar firmly believes the VA’s transplant program is sound, there are signs changes may be are in the works.

After our investigations aired in August, the VA approved Arch to have his lung transplant done in his hometown instead of traveling to Wisconsin.

McBride says the agency has also tentatively allowed 14 other veterans to move forward with transplants locally through Veteran Choice, a program the whistleblower says he hasn’t been able to use before.

Funding for those local transplants is not final, but veterans like Arch are cautiously optimistic.

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