September 30, 2016
Kansas City, Kan. — Doctors and other liver transplant professionals across the U.S. continue to vote down a proposal backed by the United Network for Organ Sharing (UNOS) that would shift livers from one population base to another. In every case, the shift forces the flow of livers from smaller, often rural areas with higher Model for End-Stage Liver Disease (MELD) scores – which helps determine when a patient gets a transplant – at transplant and waiting list mortality to bigger, primarily coastal cities with lower MELD scores at transplant and waiting list mortality.
The overwhelming consensus among health professionals in the transplant community is that the proposal, which is currently seeking public comment, is "fundamentally flawed." Critics say it results in zero lives saved, fewer transplants (200 fewer per year, according to UNOS), and reduces access to transplantation for patients in the South, Midwest and Northwestern parts of the country – many of which have high percentages of minority populations. The proposal also threatens the economic and structural healthcare delivery systems throughout large areas of the South, Midwest and Northwestern states by forcing 30 donor service areas to export between 2% to 46% of the donor livers.
Doctors and transplant professionals add that UNOS' proposal will result in unnecessary transplantation costs and unacceptable increases in workload and risk to transplant professionals. Perhaps the biggest flaw of all is the UNOS proposal provides no incentive for areas with fewer organ donors to work on increasing donation.
Despite the many complaints and votes of "no confidence" in the proposal, UNOS president, Dr. Stuart Sweet, says the regional votes don't count "in any way, shape or form" in UNOS' final decision.