Transplant Network Backs New Criteria

Associated Press

The nation's organ transplant network yesterday approved new rules for distributing scarce livers aimed at making sure the sickest patients are truly at the top of the waiting list.

Network officials say the new system, which uses sophisticated, medical criteria to rank patients, will do a much better job predicting who is most likely to die without a transplant. How long a patient has been waiting, which plays a significant role in ranking patients today, will become much less important.

But the changes endorsed do nothing to break down geographic barriers that keep most organs in the communities where they are donated, even if there's someone sicker in the next city or state over.

The United Network for Organ Sharing endorsed the plan, 32-0, and will now submit it to the Department of Health and Human Services for approval. HHS officials, who have been demanding more far-reaching changes, said they are prepared to accept the proposal, at least for now. While HHS is reviewing the proposal, transplant officials will apply the new standards to patients to assess the effect of the new rules. But the rules will not actually be used to distribute livers until the agency grants its approval, which is expected to take several months.

The problem comes down to supply and demand. In 1999, there were 4,698 liver transplants performed, but 1,753 people died waiting. More than 16,000 liver patients are waiting today. Transplant centers, which depend on a reliable stream of donated organs to run their programs, also have an interest in maximizing the number of organs that come their way.

Organs are now offered first to patients within a local area, sickest first, and if there are no local matches, to others in the region. If there are no regional matches, the organs are offered to patients in other parts of the country.

A network committee considered 17 plans for sharing livers over broader areas and a majority concluded that none of them would save a substantial number of lives, said Richard B. Freeman Jr., a liver surgeon at Tufts University who chaired the committee.

Copyright © 2000 The Washington Post Company.

This article posted January 25, 2001.