Proposal to Ship Donated Livers From Rural to Urban Areas Will Cost $30 Million More Annually, Will Not Save More Lives: The University of Kansas Hospital

KANSAS CITY, Kan., Sept. 3, 2014 /PRNewswire/ -- Doctors at The University of Kansas Hospital are joining 45 liver transplant programs from Missouri, Florida, Texas, Colorado, Georgia, North Carolina, Virginia, Ohio and Michigan, among others, calling on the United Network for Organ Sharing (UNOS) to delay consideration of a controversial proposal to distribute livers nationally instead of regionally. 

Collaborating doctors say that, despite claims of the UNOS "Share 35" proposal, more lives will not be saved. In addition, patients with liver illnesses in affected regions will be put at greater risk and the plan will add an estimated $30 million annually to liver transplantation costs -- paid for largely by taxpayers.

Currently, sharing of donor livers happens among the sickest patients within 11 designated regions. Now, UNOS is proposing expansion of the regional borders which will result in donor livers traveling even greater distances. Doctors with the programs above are certain that regions required to export livers will see more patients in those regions growing sicker while waiting longer for a transplant and surviving less. Doctors say much more data must be collected over the next two years on the impact of such a plan before making sweeping changes to existing policies. 

"We know UNOS is working with every resource available to find a better way, but it is not good medicine to rush into radical change without a good understanding of unintended consequences," said Dr. Richard Gilroy, MD, medical director of liver transplantation at The University of Kansas Hospital. 

Increasing Organ Donations
In the Midwest Region 8, organs are donated at a higher rate (82 percent) compared to anywhere else in the nation. Rather than taking organs from higher donation areas in the Midwest, South and Southeast, and giving to patients in large coastal cities that do not have higher donation rates such as New York (55 percent) and California (71 percent), doctors propose a different solution.       

"The only way to save more lives is to increase organ donation in other regions," said Dr. Timothy Schmitt, MD, director of transplantation at The University of Kansas Hospital. "Flying livers across the country from high donation regions to lower donation regions removes any incentives for those donation programs to get better."

More importantly, Dr. Schmitt noted, "By simply reallocating where livers go without increasing donations, you only change where people die waiting for a liver. Areas which can transplant at a lower MELDS (medical severity score) only do so because of the generosity and spirit of donation in those communities."

Sharing Among Regions Already Happens
The Midwest Transplant Network shared more than half of all donated organs with other regions and 34 percent of all livers with other regions last year, so the region's excellent donation rate already helps other parts of the country. The Midwest Transplant Network, Gift of Life, donor families, Region 8 organ recipients and health care leaders are calling on the public to register to donate organs in all Regions across the United States – especially the areas that have lower donation rates – and for UNOS to slow the process of adopting a new allocation proposal until it is thoroughly vetted including more data and unintended consequences.

"The foundation of all organ transplants is the gift of donation," said Dr. Schmitt. "By partnering with the local organ procurement organizations, as we do with Midwest Transplant Network as well as Gift of Life, we have proven donations can be significantly increased.  It's hard and challenging work.  Increasing donations should be the number one priority, instead of spending resources on a risky allocation plan."

Added Travel Times for Livers
Travel times also affect the health of livers and prognosis for successful transplants. "With the new proposal, there will be more cold time on organs shared nationally instead of regionally," said Dr. Gilroy. "It will be on ice longer and it may not work as well."

Members of the Region 8 transplant community will travel to Chicago September 16, to participate in a public hearing before UNOS.

VIDEO:  Members of the transplant community in highest performing donor region explain how coastal programs can improve their "donor conversion" (people who both register and are eligible to donate).  Warning: video includes graphic surgery images  https://www.youtube.com/watch?v=nu-ge6NEZTc

SOURCE The University of Kansas Hospital