The United Network for Organ Sharing (UNOS) has gone back to the drawing board on a proposal that was meant to dramatically change the way donated livers are distributed across the United States for transplants.
The organization’s plan, meant to help ease regional disparities in the availability of livers across the country, has become one of the most contested issues in transplant history, The Boston Globe reports.
UNOS’s idea was to fly livers from states in the South, Midwest and Northwest, which often have more donors than the rest of the country, to places like New York, California, Massachusetts and Minnesota, where donated livers are in much higher demand. To do this, UNOS would have redrawn the nation’s 11 transplant regions into eight larger districts. But since it was released for public comment this August, the plan has met with backlash from doctors, patients and health advocates across the country.
In response to the proposal, many have argued that rural patients already have inferior access to health care and that taking away donated organs from these areas will exacerbate the problem. In the Midwest, some have accused doctors in the Northeast of taking “the easy way out” with this proposal instead of pushing to increase donations in their own cities. Another criticism is that transporting livers across the country could lead to degradation of the organs.
Physicians in the Northeast and other larger cities, on the other hand, have accused their colleagues at smaller transplant centers of worrying about revenue at the expense of a fair transplant system for patients.
At this point, transplant experts say they’re not sure whether the medical community will ever reach a consensus on UNOS’s plan, noting that previous attempts to fix geographical disparities in liver transplants have also ended in intense disagreement across the community. Although this latest proposal had already been researched and vetted with surgeons for two years, it appears the U.S. transplant community is no closer to reaching a consensus.
In the meantime, the waiting list for transplanted livers continues to rise across the United States, with more than 14,500 patients across the country currently awaiting life-saving surgery. Patients in high-demand regions who have money may be able to travel to obtain more favorable odds for a liver transplant. However, for the majority of those in need, the difference between life and death could be a simple matter of geography.