Tuesday, February 18, 2020

New liver-transplant rule will mean longer waits for many rural patients, say health-care officials fighting the change

A new federal policy governing how donated livers are allocated is being criticized by health-care officials who say rural patients, especially in the South and Midwest, will have to wait longer for a transplant. The Department of Health and Human Services' Organ Procurement and Transplantation Network, which runs the nation's transplant system, implemented the policy on the recommendation of the United Network for Organ Sharing, a private non-profit organization.

Under the old system, local patients had priority when a liver became available. Wealthier patients sometimes traveled to other states to get on shorter waiting lists, but the new rule is meant to level the playing field. Under the new rule, livers will be offered first to the sickest patient in a 500-mile radius. "Patients that aren't as sick living in areas where there are more organ donors, such as parts of the South and Midwest, likely will wait longer as livers once used locally are shipped to urban centers where the shortage is more severe," Lauran Neergaard reports for The Associated Press.

"As a federal judge in Atlanta has already noted, the . . . rule change means regional patients awaiting transplants, many of whom live in rural and lower socioeconomic areas, will no longer be first in line to have their lives saved," writes the editorial board of the Kansas City Star. The judge ruled in a suit against OPTN and UNOS by a group of hospitals opposing the policy.

UNOS officials say the policy will save 100 more lives per year than the old policy, but many doctors in the South and Midwest disagree, Jayla Whitfield reports for Fox News.

Though the rule is well-intentioned, the rulemaking process was rushed and deeply flawed, write University of Kentucky and University of Louisville health care officials in an op-ed for the Lexington Herald-Leader and Kentucky Health News. The new rule, they write, will decrease rural access to livers, will increase costs because of increased travel (both for the livers and the patients), will result in longer waiting periods and poorer health outcomes for people who have to wait longer for donated livers, and will increase the likelihood that some patients will die while waiting for a liver.

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