Geographic disparities in access to organs remain a major issue in the U.S. Some in the transplant community say a proposal to fix the problem focuses too much on “shuffling organs” and too little on boosting low donor rates.
During a heated public forum last year, the United Network for Organ Sharing suggested a major redesign of the system for allocating livers. But some attendees said the proposed model wouldn't solve the problem of low donor rates.
UNOS, the not-for-profit that contracts with the federal government to oversee the organ transplant system, will present a revised version of the system redesign at a liver distribution forum on June 22 in Chicago. The group will seek public comment. The model could become policy by mid-2016.
“Whatever we come out with will be a lot better than what we have now,” said Dr. David Mulligan, chair of the group's liver and intestinal organ transplantation committee. The current system contributes to widening disparities in liver transplantation rates. The proposed concept “will involve some compromises,” he said. “But this is all about trying to do the right thing for patients.”
Still, disagreement persists on the idea of shifting regional prioritization for patients on the waitlist while only marginally addressing varying donation rates around the country. “I was not in favor of the concept last year and I'm still not,” said Dr. David Goldberg, assistant professor of gastroenterology at the University of Pennsylvania School of Medicine.
A recent study in JAMA Internal Medicine indicated that policies in many states have failed to increase donation rates. But at least a few states have boosted donations, Goldberg said. “Clearly there is potential,” he said. “Something they are doing must be working.”