Organ Network Changes Liver Policy
WASHINGTON, Jun 24, 1999 (AP Online via COMTEX) -- More donated livers
will be directed to the sickest transplant patients under a new policy
approved today by the nation's transplant network.
The United Network for Organ Sharing is also poised to release data
about individual transplant centers for the first time, including the
survival rates of their patients.
In both cases, the changes represent a retreat for the network after
more than a year of defending its current system under pressure from
the Department of Health and Human Services.
HHS issued rules last year ordering the network to create a new system
that would get more organs to the sickest patients. But the network has
insisted on its system, which relies heavily on geography.
The HHS rules also called for the network to release more data, but
transplant centers have balked, saying it was unfair to release
potentially embarrassing or misleading data about individual hospitals
and doctors.
Hoping to stop these rules, the network mounted an intense lobbying
effort and persuaded Congress to delay them until the fall.
But, meeting today in Atlanta, the board moved closer to what HHS
wants.
In distributing donated organs, the liver policy has engendered the
fiercest debate, partially because there is an acute shortage of livers
and very few other medical options for patients who need new ones.
The policy adopted today will direct more livers to the sickest
patients -- those classified as ''status 1.'' These are people who are
suddenly struck by liver disease and have a week or less to live.
Under the current system, livers are offered first to status 1 patients
in the local area. If there are no medical matches, they are offered to
other local patients, in order of medical urgency. If there are still
no local matches, livers are offered to patients in the surrounding
region, sickest first.
The new policy would kick in if there are no local status 1 matches. In
this case, livers would be offered to status 1 patients throughout the
region before being offered less urgent local candidates.
Under current policy, 9.7 percent of donated livers go to status 1
patients. The network expects that to rise to 14.3 percent under the
new policy. The percentages going to less urgent patients -- those in
status 2A, 2B and 3 -- all drop slightly.
The HHS regulation wanted the network to go further, although
government officials have said they are willing to compromise. The rule
called for the elimination of geographic boundaries, while the new
network policy still relies on regional lines.
A liver donated in Cleveland, for instance, might be directed to
someone who is relatively healthy even if there is a status 1 patient
in nearby Pittsburgh, because the regional line is drawn between
Pennsylvania and Ohio.
Nationally, there are 63 local areas and nine regions.
Copyright 1999 Associated Press, All rights reserved.
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By LAURA MECKLER
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