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  • Transplant patience pays off

    Daily Oklahoman, Oklahoma
    Distributed by McClatchy-Tribune Business News
    January 17, 2008 Thursday


    Transplant patience pays off


    by Jeff Raymond, The Oklahoman

    Jan. 17--Cutting months from the wait to receive a liver and having a
    longtime acquaintance in the operating room convinced a California
    surgeon to bring his father to Oklahoma City for a liver transplant.

    Dr. Avo Artinyan trained as a surgeon under Dr. Nicolas Jabbour, who
    now oversees the Integris Nazih Zuhdi Transplant Institute. Jabbour
    operated Jan. 9 on 66-year-old Ludvik Artinyan, a Los Angeles family
    practice doctor from Armenia.

    Avo Artinyan, who is halfway through a surgical oncology fellowship
    in Los Angeles, estimated his father would have waited at least
    another six months to have a transplant, had he stayed in California.

    Transplant patients in Oklahoma typically spend less time waiting for
    livers than the national average. Because patients may be listed on
    multiple organ waiting lists, Ludvik Artinyan's chances of receiving
    a liver were better if he came to Oklahoma.

    Half of the patients placed on the liver waiting list in the state
    receive a transplant within approximately eight months of being
    listed; nationally, it is double that time.

    Joel Newman, a spokesman for the United Network for Organ Sharing,
    said the organization's policies allowed patients to list at more
    than one transplant site.

    However, he said, "It's very uncommon that people list at more than
    two."

    To qualify, patients must meet the sometimes-differing criteria of
    individual transplant centers.

    Although listing at two centers served by the same organ procurement
    organization such as Oklahoma's LifeShare Transplant Donor Services
    won't improve a patient's transplant chances, odds can improve by
    registering elsewhere because organs may become available sooner.

    A growing tumor on Ludvik Artinyan's liver made waiting ill-advised;
    had the tumor grown more, he would have been ineligible for a
    transplant.

    His MELD (model for end-stage liver disease) score, a way of ranking
    transplant candidates according to the severity of their illnesses,
    wasn't high enough to be at the top of the list in Los Angeles.
    Organs are in greater demand there because of a dense population that
    is more prone to liver disease because of its ethnic makeup.

    Artinyan knew he wanted to bring his father to the Oklahoma-Texas
    area, and asked colleagues about where to go.

    They suggested Jabbour.

    Doctor is a big factor

    Artinyan said the greatest compliment one surgeon can pay another is
    to have him or her operate on a loved one.

    "He's one of only a few people I would have let operate on my dad,"
    Avo Artinyan said.

    He called Jabbour "gifted," a surgeon who operates quickly but
    precisely and a challenging teacher while at the University of
    Southern California.

    "I would definitely recommend other people come out here," Avo
    Artinyan said, calling the transplant center "a little hidden jewel."

    The center's success rate, and its dedicated post-transplant ICU and
    organ-harvesting team -- most transplant centers have different teams
    for different organs -- helped sway Avo Artinyan. Time is of the
    essence when harvesting organs, and different teams often have
    competing interests in getting their organs out first, he said.

    Ludvik Artinyan has been in Oklahoma City since Nov. 27 waiting for a
    new liver. He likely will leave the hospital today. He will remain in
    the city for a week or two and then return to California.

    Trusting his son

    As for coming to Oklahoma, he said he trusted his son and had heard
    of Jabbour through colleagues.

    "They said he has excellent technique, very honest, good man," Ludvik
    Artinyan said.

    Jabbour said the center's organ-harvesting team impressed a review
    team recently. He said having his former student choose his hospital
    was both a personal choice and "an educated guess."

    "Educated people will find out about our program and will seek us
    out," he predicted, adding that he currently has patients from
    California and Alabama who await transplants.

    Although the nation's pre-eminent transplant centers doubtless
    provide good care, they're not the only ones.

    "This can be done locally by some of the best physicians," Jabbour
    said.

    Baptist surgeons perform about 60 liver transplants a year.
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