Guest Commentary

Misguided changes to national liver allocation policy will hurt Kansas City-area patients

Sens. Roy Blunt of Missouri and Jerry Moran of Kansas
Sens. Roy Blunt of Missouri and Jerry Moran of Kansas

In 2017, 18 people in the Kansas City area died waiting for a liver. Nationwide, more than 113,000 people sit anxiously on a waitlist. Unfortunately, the odds are not favorable for an individual in need of a life-saving organ transplant. And for those in the Midwest, those odds just got worse.

The board of the organization charged with managing the distribution of life-saving organs — OPTN, the Organ Procurement and Transplantation Network — recently made changes to the national liver allocation policy that will benefit urban areas and densely populated states such as New York, Massachusetts, and California — at the expense of Midwestern and Southern states and rural communities, including Missouri and Kansas. Under the new plan, Missouri could lose 32 percent of livers from Missouri donors. In Kansas, it would be even higher: 45 percent.

Under the current liver allocation policy, the Midwest has thrived by establishing some of the best transplant centers and procedures in the nation. Donated livers are matched with transplant candidates first at the local level, then regionally and finally at the national level. Our medical and transplant professionals have also achieved the highest rates for organ donation in the country.

In December of last year, OPTN rushed to approve a new liver allocation policy that will begin this year. The practical effect of the new policy will be to redistribute livers from states and regions with high rates of organ donation to areas that have historically underperformed.

The OPTN decision appears to simply be a reaction to litigation from individuals in underperforming organ transplant regions who challenged the allocation based on geography. The board disregarded recommendations made by a panel of experts comprised of transplant specialists and medical experts formed to advise and inform the decision. The OPTN decision makers have tried to justify the change by saying the sickest patients will receive transplants. While their reasoning may sound good on the surface, it will actually do more harm than good by doing nothing to boost the overall supply of livers.

We believe the overarching goal should be to improve organ donation rates everywhere. Instead of evaluating and improving the organ procurement methods in underperforming geographic areas, OPTN decided to penalize successful organ transplant areas and reward underachieving ones.

This shortsighted liver allocation policy rushed through by OPTN will not only mean fewer life-saving organs in our part of the country, but it will also adversely affect health outcomes throughout the Midwest. In December, we wrote a letter to the Department of Health and Human Services regarding this flawed organ allocation decision. And in January, we joined 20 of our Senate colleagues in sending a second letter to HHS Secretary Alex Azar outlining our questions regarding the process and potential consequences of the new policy.

The manner by which OPTN’s decision was reached calls into question the process for which liver allocation decisions are made. We now have both a flawed policy and a flawed process.

The transplant hospitals and medical communities in Missouri and Kansas are successfully reducing organ transplant wait times and developing innovative procedures to save lives. We will continue to advocate for their success.

Republican Sen. Roy Blunt represents Missouri in the U.S. Senate. Republican Sen. Jerry Moran represents Kansas in the U.S. Senate.

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