An obscure but important debate over how livers are obtained for liver transplants is edging its way to Congress, and may be joined later this summer.
At issue is the complicated system for getting donated livers to transplant recipients who need them. The system was designed to replace the haphazard liver distribution system of the 1980s and 1990s.
The system is now administered by something called UNOS — the United Network for Organ Sharing, a private group that manages available livers under a federal contract. UNOS uses a formula based in part on geography: available livers are distributed locally first, through so-called “donation service areas.”
The group is now re-thinking that formula. It turns out that some areas of the country have fewer livers available than others, and the new rule is aimed at distributing available organs more broadly.
Which isn’t making high-liver-donation areas very happy, including those in and around Kansas City.
They say local patients shouldn’t be penalized because donation rates are poorer on the east and west coasts. They also say the new system won’t do much to improve outcomes on the coasts.
They also say areas with fewer livers should work harder to get donations, rather than redraw lines to get organs from places with high donation rates.
UNOS may vote on a new distribution system by the end of the year. Rep. Kevin Yoder has written the Health Resources and Services Administration, pushing back against the proposed changes.
“I’m very concerned about efforts by large east coast hospitals to try to change the rules of organ sharing in this country to essentially take organs from the Midwest and reallocate them to the coast,” he said.
“The answer to the challenges we have in organ shortages is to work together to increase the amount of organs donated nationwide as opposed to try to redistribute organs from areas that have higher organ donation rates.”
Doctors in at least 25 states have written with concerns about the plan.
Supporters, though, say changing the rules could improve survival rates among east and west coast patients without seriously hurtinh patients in high-donation areas.