Fewer Lives Saved, Millions More in Costs: Proposal to Export Donated Livers From Rural Areas to Big Cities Threatens Transplant Programs and Patients on Wait Lists
KANSAS CITY, Kan., Aug. 23, 2016 /PRNewswire/ -- A UNOS proposal to "re-district" liver donation regions so more livers will be exported from rural areas in the South and Midwest to coastal cities in the Northeast and California will actually add more costs and won't save any more lives, a recent UNOS report acknowledges.
According to the UNOS proposal released on Aug. 15, 2016, the changes would:
- INCREASE liver transport time by up to 11 percent
- INCREASE liver transportation distance by up to 87 percent from a median of 124 miles to up to 232 miles)
- INCREASE the number of livers that would need to be flown by chartered aircraft by 14 percent (the proposal states that up to 73.1 percent of livers could be flown)
- INCREASE the cost to hospital transplant centers and organ procurement organizations due to additional and extended transportation requirements of the new proposal
- DECREASE the number of liver transplants by two percent
"A proposal that does not save any more lives, almost doubles the transport time of these vital organs and costs the healthcare system more money is not a proposal that everyone should be so quick to support," said Dr. Sean Kumer, surgical director of transplantation at The University of Kansas Hospital. "We believe that everyone deserves a fair chance at liver donations, but this adds more problems than it provides solutions. Flying organs also poses a risk to the livers and transplantation teams that are flying greater distances and more often to recover organs. It's time and energy that also drives up the costs of transplants without saving more lives."
Flying nearly three out of four donor livers not only is more costly, it's much riskier because delays with thunderstorms, snow storms, hurricanes and other weather-related issues that impact small charter flights.
One of the solutions for increased liver donations is to increase the pool of organ donors, especially in areas that have long patient wait lists. Areas in the Midwest and South have worked hard to develop specific programs encouraging organ donations, while areas such as New York have left nearly $1 million on the table earmarked for donation awareness efforts.
"Donors are not a commodity. They are human beings with families and give a great gift," said Dr. Timothy Schmitt, director of transplantation at The University of Kansas Hospital said. "The whole system is based on people giving. Disparity in donation should be the focus -- not the shipping of livers."
A letter opposing the latest UNOS proposal was signed by organ transplant specialists from 55 liver transplant programs in Kansas, Missouri, Florida, Texas, Colorado, Georgia, North Carolina, Virginia, Illinois, Indiana, Ohio, Michigan, Virginia and Washington and 11 other states and recently sent to UNOS urging it to reconsider its proposal. This was a follow-up to a letter signed by more than 50 lawmakers sent to UNOS in 2014 expressing concerns about re-districting.
In fact, among the 16 doctors on the UNOS committee that proposed the changes, four of them actually signed the letter opposing the proposal. The leaders of the committee represent transplant centers that would stand to gain an advantage with the new proposal.
In the Midwest Region 8, organs are donated at a higher rate (82 percent) compared to anywhere else in the nation and a significant amount are already shared outside of its region. Rather than taking additional organs from higher donation areas in the Midwest, South and Southeast, and giving even more to patients in large coastal cities that do not have higher donation rates such as New York (55 percent) and California (71 percent), many doctors are proposing a different solution.
"The only way to save more lives is to increase organ donation in other regions," said Schmitt. "Flying more livers across the country from high donation regions to lower donation regions removes any incentives for those donation programs to get better at the local level - which is essential in building strong regional transplant centers for patients. More importantly, by simply reallocating where livers go without increasing donations, we don't save more lives. The new model actually predicts lower transplants at a higher cost."
Jeff Orlowski, president and CEO of LifeShare in Oklahoma City believes further re-districting will continue to reduce the number of liver transplants in regions like his with less access to healthcare. He points to the most recent re-districting which led to a 300 percent increase in the export of locally donated livers. A video of his story is here: https://www.youtube.com/watch?v=Y3zoxc5bzB4.
UNOS has opened the public comment period on this proposal on its site: https://optn.transplant.hrsa.gov/governance/public-comment/redesigning-liver-distribution/
Those interested in liver donation are encouraged to review the proposal carefully, consider all of the facts presented and provide feedback.
The University of Kansas Hospital is the region's premier academic medical center, providing a full range of care. The hospital is affiliated with the University of Kansas Schools of Medicine, Nursing and Health Professions, and their various leading-edge research projects. The constantly growing facility contains 756 staffed beds (plus 24 bassinets) and serves more than 33,000 inpatients annually. Eleven of its medical and surgical specialty areas are ranked nationally by the U.S. News & World Report "Best Hospital" lists, including Cancer (#25), Cardiology & Heart Surgery (#38 tie), Diabetes & Endocrinology (#33), Ear, Nose & Throat (#31), Gastroenterology and GI Surgery (#35), Geriatrics (#13), Gynecology (#38), Neurology & Neurosurgery (#22), Orthopedics (#35), Pulmonology (#28) and Urology (#17). The cancer program is part of The University of Kansas Cancer Center, a National Cancer Institute-designated program. The hospital has received Magnet nursing designation, reflecting the quality of care throughout the hospital, an honor awarded to only 7.8 percent of the hospitals nationwide. The hospital also houses the region's only accredited burn center, the area's only nationally accredited Level I Trauma Center and the area's first Advanced Comprehensive Stroke Center recognized by The Joint Commission. For more information, visit kumed.com.
SOURCE The University of Kansas Hospital
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