Hospital Amaral Carvalho (HAC) Jaú
Once upon a time, in a place, far, far away, there
was an Oncology Hospital:
Serviço de Transplante de Medula Óssea
Fundação Hospital Amaral Carvalho (FHAC) – Jaú-SP
Hospital Amaral Carvalho (HAC)
1994
Philanthropic Foundation (not a university hospital)
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Priority: care of patients of the public health system;
200 beds predominantly surgical;
Radiotherapy;
Chemotherapy (400/months) 10% hematological-oncology;
Blood Bank:
 Not enough blood products;
 Coordinated by the surgical area;
 Serology laboratory at the city’s health department, not
at the hospital;
Serviço de Transplante de Medula Óssea
Fundação Hospital Amaral Carvalho (FHAC) – Jaú-SP
Hospital Amaral Carvalho (HAC)
Goal:
Develop Hematology/Hemotherapy;
Find a solution to our patient’s difficulties to HSCT;
Option:
Develop HSCT program;
Serviço de Transplante de Medula Óssea
Fundação Hospital Amaral Carvalho (FHAC) – Jaú-SP
Hospital Amaral Carvalho (HAC)
1994 – Strategy:
Dr. Paulo Machado
 Cooperation with the Medical School of Botucatu (FMB);
 Access to laboratories: Flow Cytometry and Molecular
Biology;
 Botucatu Hematologist’s Residents training in HAC;
• Embryo of the medical residency program at HAC,
accreditated in 1996;
 Support from SP’s State Health Secretary to create the
HAC Hematology and Hemotherapy Center under the
coordination of Dr. Marcos Mauad;
Serviço de Transplante de Medula Óssea
Fundação Hospital Amaral Carvalho (FHAC) – Jaú-SP
Hospital Amaral Carvalho (HAC)
1994 – Development of Hemotherapy HAC:
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Increase number of blood products;
Leucodepletion of blood products;
Irradiation of blood products;
Apheresis - platelets;
Labs;
Serviço de Transplante de Medula Óssea
Fundação Hospital Amaral Carvalho (FHAC) – Jaú-SP
Hemonúcleo Regional de Jaú
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Serology Laboratory
Immunehematology
Cryopreservation Lab
Fractionation Laboratory
Apheresis
Serviço de Transplante de Medula Óssea
Fundação Hospital Amaral Carvalho (FHAC) – Jaú-SP
Hospital Amaral Carvalho (HAC)
1995 – We went to the Board of Directors:
We want to establish a SCT unit here
He said: “There is no budgetary provision at the HAC for this
project. But you are allowed to get any help you can”:
 Donation from pharmaceutical companies (we needed to
perform 4 transplants without reimbursement before
accreditation);
• Drugs (GCSF, Antibiotics, etc);
 Donation from patient’s family and local CEO’s;
• Equipments;
Serviço de Transplante de Medula Óssea
Fundação Hospital Amaral Carvalho (FHAC) – Jaú-SP
Hospital Amaral Carvalho (HAC)
 Meanwhile, the hospital administration performed a
renovation of the Unit at the end of the corridor, with a
single isolation room without HEPA filter;
Serviço de Transplante de Medula Óssea
Fundação Hospital Amaral Carvalho (FHAC) – Jaú-SP
Development of a HSCT Program
 But there was a little problem: we did 19 procedures, 18 of
them without reimbursement
4
 Another little problem:
Further  Our income was 30% less
than all the other University Centers;
15
Aug/96 a
Jul/97
Autollogous
Allo Related
Serviço de Transplante de Medula Óssea
Fundação Hospital Amaral Carvalho (FHAC) – Jaú-SP
Quickly we learned to say to
the Administration: It’s not
cost, It’s investment...hehe
Keep on Walking
Development of a HSCT Program
 So... We did 19 procedures without reimbursement;
 Further  Our income was 30% less than theirs;
 Finally in aug/2001  Reimbursement: 100%;
Team going forward
Serviço de Transplante de Medula Óssea
Fundação Hospital Amaral Carvalho (FHAC) – Jaú-SP
Established HSCT Program
19
15
15
17
28
70
100
105
150
171
177
152
179
190
Serviço de Transplante de Medula Óssea
Fundação Hospital Amaral Carvalho (FHAC) – Jaú-SP
206
207
174
Dr. Marcos de Lima
Dr. Claudio
Brunstein
Dr. Wellington
Dra. Carmen Bonfim
Dr. Bouzas
Dra. Adriana Seber
Dr. Vanderson Rocha
Dr. Hans Kolb
Dr. Júlio Voltarelli
19
15
15
Dr. Marcos Bittencourt
Dra. Belinda
17
28
70
100
105
150
171
177
152
179
190
206
207
174
HSCT (n=2.000)
10/Aug/1996 – 09/Aug/2013
Serviço de Transplante de Medula Óssea
Fundação Hospital Amaral Carvalho (FHAC) – Jaú-SP
HSCT (n=2.000)
10/Aug/1996 – 09/Aug/2013
2
97
10
4
7
132
4
5
1
1
3
15
46
51
11
48 238 10
1
6
69
36
136
32
16
843
183
São Gabriel da
Cachoeira
Manaus
>4.000 Km de distância
Jaú
“Dr. Mair
Jaú is at the
end of the
World!”
Jaú
Dr. Mair
August, 2000: Our data been presented for
the first time during SBTMO/Curitiba
(Odilio, 2005)
São Gabriel da
Cachoeira
Far, far away...
Manaus
Jaú
Dr. Júlio Voltarelli
Dra. Belinda
Serviço de Transplante de Medula Óssea
Fundação Hospital Amaral Carvalho (FHAC) – Jaú-SP
Cooperations
 GeDech
GeDeco
Dra. Mary Flowers
Serviço de Transplante de Medula Óssea
Fundação Hospital Amaral Carvalho (FHAC) – Jaú-SP
What you need to establish a SCT center?
Committed persons!!!!!