NoBlood

Issue Date: September 15, 2007, Posted On: 9/14/2007

U.S. man first to turn to India for liver transplant surgery
BY CHRIS NELSON

CONCORD, Calif. — When Kevin Stewart's doctor told him late last year that he had advanced cirrhosis of the liver and would need a transplant or face certain death, Stewart never thought that his salvation existed half a world away in India.

That changed when Stewart, a resident of Big Pine Key, Fla., learned of the cost to have the procedure done in the United States — about $350,000 — and after the federal government and public and private hospitals repeatedly rejected his pleas for financial assistance.

Stewart, his options exhausted, discovered almost by accident WorldMed Assist LLC, a California company that arranges high-end medical treatment abroad for its clients at prices that are far less-expensive than what they would pay in the United States.

Concord-based WorldMed Assist took Stewart on as a client and arranged for him to travel to India earlier this summer for a liver transplant surgery. His sister, Jo-Ann Hall of Ottawa, Canada, donated a portion of her liver to Stewart — a procedure known as live-donor liver transplant. Subhash Gupta, a liver-transplant specialist with Indraprastha Apollo Hospital in New Delhi and the chief of the hospital's liver surgery unit, performed the transplantation.

Stewart paid approximately $55,000 for his surgery and hospitalization — $275,000 less than what it would have cost to have it done in the United States. "Having this surgery in the [United States] would have wiped me out," Stewart said. "Having someone help me get the transplant I needed in India — with top-notch doctors in a great hospital, at a fraction of the cost — saved me so much money that I flew my girlfriend and Jo-Ann's husband to India to help us recuperate. This surgery has given me back a life I thought was lost."

WorldMed Assist was founded in October 2006 by Wouter Hoeberechts, 37, a Dutch entrepreneur with a background in management consulting, who recognized the need for low-cost, quality health-care options for Americans.

"At the start of 2006, I read an article about [medical tourism]. Ever since I arrived in the U.S. from the Netherlands, I've known that improvements to the U.S health-care needed to be made," Hoeberechts said. "My wife's father is an internationally renowned urologist and professor in Turkey and I became fascinated with the strides that country was making in the delivery of high-quality, affordable care. I started following advances made in other countries like India, Belgium, Mexico and realized North Americans have viable low-cost alternatives that are of high quality."

WorldMed charges a flat fee of $300 for its services (separate from any medical costs). Hoeberechts, who prefers to call himself a logistical coordinator rather than a medical tourism provider, has connected 14 U.S. residents with physicians and hospitals in India, Turkey and Belgium since last October.

"We create alternatives for our clients," Hoeberechts said. "Many of the people who contact us have run out of options — they are uninsured or underinsured — and we connect them to high-quality hospitals outside the United States where they will receive excellent care for much less than what they would pay in America."

WorldMed's executive board is comprised of Hoeberechts, the company's chief executive officer; his wife Gulbin Muftuoglu-Hoeberechts, WorldMed's marketing manager; Dr. Paul Kim, WorldMed's chief medical officer; and Dr. Orkun Muftuoglu, an ophthalmologist and WorldMed's medical advisor for Turkey.

Stewart stumbled upon WorldMed when he looked up medical tourism on the Internet.

"In early June, I hit the Internet, and eventually landed on the words 'medical tourism.' I searched several firms, saying, 'I need a liver transplant.' Several responded, but I kept coming back to WorldMed Assist," Stewart said. "By late June, they had me on my way to India, and my surgery was finished July 11. Pretty amazing — I heard I was the first American to have a liver transplant in India."

Interestingly, Hoeberechts almost declined to accept Stewart as a client because of the risks associated with liver transplants. "I was initially reluctant to take Kevin on as a patient," he said. "Live liver transplants are extremely risky, no matter where in the world they're done. But I knew of Dr. Subhash Gupta at one of WorldMed Assist's contracted hospitals (Apollo in New Delhi); we did our research and gathered references — Dr. Gupta has done 120 live liver transplants with a long-term survival record that surpasses the Mayo Clinic's, the U.S.'s gold standard for liver transplants."

Gupta, who received his surgical training in the United Kingdom, pioneered the practice of "bloodless surgery," an approach that involves the delivery of medical and surgical care without the transfusion of blood products. The technique has long been applied to Jehovah's Witness patients, but it is now experiencing widespread popularity with other patients due to the lessened risk of infection and immunologic complications.

"We were blown away by Dr. Gupta," Hoeberechts said. "I don't think you'll find a better-qualified liver-transplant surgeon anywhere."

Stewart returned to the United States Aug. 24 after spending two months in India. He is currently recuperating at his house in the Florida Keys, and says he feels "wonderful."

"I feel great — I haven't felt this good in years," he said via telephone. "Every day is better than the one before it, and I'm constantly wearing a smile. I can't say enough about what Wouter and WorldMed Assist have done for me."

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