New Contract For Transplant Network May Settle Fight

WASHINGTON (AP) -- Renewing its federal contract, the private network that runs the nation's transplant system has agreed to direct more organs to the sickest patients and to give the government final say over policy for the first time.

There was some question whether the United Network for Organ Sharing, which has run the transplant system since 1987, would get a new contract at all after a bitter fight with the Department of Health and Human Services over policies over distribution of scarce organs and who should set them.

Under the new, three-year deal announced Thursday, UNOS will continue to maintain the list of people waiting for new organs and run the computers that match waiting patients with donated organs. And with another bidder looking to take over, the Richmond, Virginia-based firm acceded to HHS's long-standing demands, which are now written into their agreement.

"We can effect the policies the best by remaining the contractor," said UNOS spokesman Mark Rosenker. "It would have been a tremendous loss for the community," he added, if it had gone to another company.

But UNOS was not the unequivocal victor.

The University Renal Research and Education Association of Ann Arbor, Michigan, was picked to run the Scientific Registry of Transplant Recipients, which crunches data on how transplant patients fare and examines the ramifications of changes to distribution policy. UNOS had done this since 1987.

HHS hopes the Michigan contractor will provide a check on UNOS by allowing outside analysts to examine policies that UNOS proposes.

"There's no vested interest to have it come out one way or another," said Dr. Claude Earl Fox, administrator of the Health Resources and Services Administration, the HHS branch that oversees the transplant system.

The Michigan firm will also be responsible for producing reports to HHS and the public about the transplant system. UNOS has come under fire in the past for failing to produce timely and specific data.

Tensions between HHS and UNOS grew in 1998, after HHS directed that UNOS break down geographic barriers that govern the system, direct more organs to the sickest patients and get HHS approval for its policies.

UNOS and its allies bitterly fought those rules. Congress put them on hold several times before they finally took effect early this year. Then the House voted to strip HHS of its power over transplant policy, effectively overturning the regulations. The Senate has worked hard on compromise legislation, but no bill has passed both houses.

The new contract nullifies much of the debate by requiring UNOS to abide by each of the regulation's provisions. So even if the regulation were overturned, the transplant network is bound by contract to break down geographic barriers and get more organs to the sickest patients.

The decision over the transplant contract was widely anticipated. The only other bidder was the Pittsburgh-based Center for the Support of the Transplant Community.

Fox said that bid was "competitive," but "not extremely close" based on objective criteria. Still, by having another bidder, HHS had additional leverage in its negotiations with UNOS.

The contract gives UNOS $1.5 million in taxpayer money in its first year and authorizes a patient registration fee of $404, paid by patients on the waiting list. That's up from $379 now. The first year of the three-year contract should total nearly $16.5 million for UNOS.

University Renal Research will get just over $2.6 million in the first year of its three-year contract. Both contracts include options to extend them for an additional two years.

Meanwhile, UNOS is considering new plans that would distribute livers across larger geographic areas and developing more detailed medical criteria to rank waiting patients.

On Thursday, some 200 experts were meeting in Dallas to refine the medical criteria. Without uniform criteria, doctors are wary of trusting one another with broader sharing of donated livers for fear the patient in another area is not really as sick as his or her doctors say.

Copyright © 2000 The Associated Press.

Copyright © 2000 Cable News Network.

This article posted September 30, 2000.