Organ donor network puts S.C. patients at disadvantage

The Medical University of South Carolina (MUSC) offers our state a nationally recognized organ transplant program, and also the only liver transplant program in the state. Since the liver transplant program began 19 years ago, 232 patients from the Midlands have received a transplanted organ at MUSC. The number of liver transplants that MUSC performs annually is in danger of decreasing, due to a potential change to the rules governing liver transplants in our state. Proposed by the United Network for Organ Sharing (UNOS), these changes could alter how livers are distributed to recipients on the waiting list, effectively sending more of those organs donated in South Carolina to other states.
Current federal regulations require that organ sharing occur predominantly for children and the sickest of patients, or those listed as “status one.” Organs must also leave the state if patients on South Carolina’s waiting list are not as sick as other liver patients in neighboring states. The proposed policy change would require the sharing of all donor livers between several states; for South Carolina, all liver donations would be shared among North Carolina, Tennessee, and Virginia. UNOS models suggest that this broader sharing policy will result in a 25 percent decrease in the number of livers available for transplant in our state, thus removing any advantage or incentive to the local community who donated the organ.
We feel that if the new policy is made effective by the UNOS Board, it would place South Carolina liver transplant patients at a great disadvantage. Patients could encounter longer wait times, with patients getting sicker, and the subsequent increased medical, emotional financial hardships. Furthermore, we are concerned that the outcomes on sicker patients may not be as good because liver organs that must travel greater distances will have an increased chance of not functioning once transplanted. This means a greater number of patients will require emergent re-transplantation. With organs traveling greater distances, South Carolinians can expect significantly increased liver transplantation costs at a time when we should be making every effort to restrain spiraling health costs. In addition, the new policy has not taken into account the effect the changes will have on access to transplant. A particular concern is the effect on minorities’ access to transplant.
UNOS is soliciting public comments from individuals as a part of their policy development process, and comments will be accepted through April 24 at http://unos.org/policiesAndBylaws/publicComment/submitYourComment.asp?PropID262 . The UNOS Web site explains that submission of information is voluntary, and responses will be anonymous and confidential. The information will be reported collectively and responses will not be associated with any individual person. A full account of the policy is located on the Web site. Comments can also be submitted by email to publiccomment@unos.org .
My hope is South Carolinians will take a moment to consider UNOS’ proposed transplant changes, and comment for themselves on what they believe is the best course of action for South Carolina.