Transplant deaths at USC a puzzle

His liver rapidly failing, William McMurrough was running out of options.

He'd been removed from the waiting list for a transplant at UCLA Medical Center for using marijuana and skipping rehab.

The 50-year-old truck dispatcher was critically ill -- with a bacterial infection and other ailments -- when he landed at USC University Hospital. He thought it was his salvation.

Surgeons there were undeterred by his deteriorating health and recent drug use. "They just took him," his wife, Linda, recalled.

Days after joining USC's waiting list in January 2005, McMurrough got a new liver. His family rejoiced, hoping he'd meet the grandson he'd felt kicking in his daughter's belly.

Many hospitals would have turned McMurrough away outright, loath to risk wasting a scarce donor organ on such a risky patient. But USC was different. It took pride in giving chances to patients with few left.

After opening its liver program in 1996, the hospital just northeast of downtown Los Angeles developed a record of success.

Then, around 2003, its death rate started to climb.

Today USC's rate is among the worst in the country. In a span of 2 1/2 years, 38 of 164 patients died within a year of their transplants, twice as many as expected, according to the most recent national data. The data largely factor in the condition of patients and donated organs.

For now, the reasons for USC's declining success rate remain largely a mystery. Prompted by an article in The Times in July, regulators and outside experts hired by the hospital are investigating.

There are several possible explanations: It could be that the program was choosing the wrong patients for transplants or using organs of poor quality. It could be that the team mishandled surgeries or follow-up care. Or it could be a combination of reasons, including bad luck.

Officials at USC's Keck School of Medicine, which runs the clinical side of the program, and at the hospital, owned by Tenet Healthcare Corp., declined to be interviewed for this article.

In a joint statement in September, however, both pointed to an answer: They were consciously taking high-risk patients.

It was an effort, they said, to provide extremely sick people with "a chance at life despite the risks of lowering our survival statistics."

In some instances the program appears to have gone too far, according to top transplant experts who reviewed medical records for The Times.