Some hospitals filed suit against new federal regulations last week aimed at giving the sickest patients better access to donated livers. The suit argues the new rules are unfair to rural communities.
Of the 13,000 people waiting for a new liver, an average of three die every day, according to the United Network for Organ Sharing (UNOS), which runs the nation’s transplant system.
The United States is divided into 11 transplant regions, which are subdivided into local areas. Each area keeps its own waiting list, and wide variations exist in organ availability both within and between regions. For the past several decades, liver donations usually went to the sickest patient within the same region first, even if a sicker patient in a different region was a good match. The new rules mandate a wider sharing of donated livers.
UNOS predicts broader liver sharing will save more than 100 lives a year because the sickest patients will be able to get a liver before those who can wait a bit longer.
But more than a dozen hospitals in parts of the Midwest and South have sued to reverse the changes. They argue that the new rules will endanger patients who live in rural areas because hospitals will be forced to ship livers to places like New York and California that typically suffer more severe organ shortages. They further note that increased travel for procurement will result in rising costs.
“We’ve been successful in doing this, and now people are coming to our area of the country to take organs,” said Sean Kumer, one of the plaintiffs from the University of Kansas Medical Center in Kansas City, Kan.
But the bigger issue is the overall short supply of donated organs, said Kevin O’Connor, president of an organ procurement organization who also heads a UNOS geography committee.
“I don’t think we can solve the fairness problem until the supply of organs exceeds the demand,” he said.
Similar sharing of lung transplants began last year, and changes for other organs are in process. —J.B.