Trans­plant docs ex­pected to clash at fo­rum on liver al­lo­ca­tions

Modern Healthcare - - THE WEEK AHEAD - —Paul Demko

The United Net­work for Or­gan Shar­ing has re­leased a pre­lim­i­nary plan to over­haul the cur­rent sys­tem for de­ter­min­ing which pa­tients re­ceive do­nated liv­ers, and many trans­plant physi­cians are gear­ing up to fight it.

UNOS, which con­tracts with the fed­eral gov­ern­ment to over­see the or­gan trans­plant sys­tem, is host­ing a fo­rum Tues­day in Chicago to dis­cuss the is­sue. Dr. David Mul­li­gan, chair of the group’s Liver and In­testi­nal Com­mit­tee, stressed that no for­mal pro­posal will be re­leased un­til at least next spring.

The dis­cus­sion arose from large ge­o­graphic dis­par­i­ties in ac­cess to do­nated liv­ers. Pa­tients in the North­east and on the West Coast are less likely to re­ceive or­gan trans­plants in a timely man­ner. In 2013, nearly 3,000 Americans died while await­ing a trans­plant or were re­moved from the trans­plant list be­cause they had be­come too sick.

“There are many peo­ple that are dy­ing ev­ery week around the coun­try be­cause they can’t get ac­cess to life- sav­ing liv­ers,” said Mul­li­gan, the chief of trans­plan­ta­tion and im­munol­ogy at Yale-New Haven Hos­pi­tal.

But the plan has sparked a back­lash from trans­plant doc­tors in states that could see re­duced ac­cess to liv­ers un­der the reap­por­tion­ment. Last month, more than 40 signed a let­ter to the Health Re­sources and Ser­vices Ad­min­is­tra­tion rais­ing con­cerns about the process. “If this pro­posal be­comes im­ple­mented with­out ad­e­quate and con­struc­tive im­prove­ments, it would rep­re­sent the most dras­tic change in liver al­lo­ca­tion ever,” they warned.

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