No ZIP Code For Gift Of Life

May 10, 2019 GMT

Recently in the U.S. District Court for the Northern District of Georgia, the debate over the new national distribution policy for donated livers continued. The new policy is projected to reduce wait-list mortality by 100 deaths each year, and it will allow more children to receive transplants. It also will correct an inequity that led to unfair advantages and disadvantages based on where liver transplant recipients reside. These are all significant benefits to patients and the liver matching system. Last year, we hit a new milestone for the most organ transplants in a single year in the United States, our sixth consecutive record-breaking year. Still, there are not enough donated organs to altogether do away with transplant waiting lists. On average, three people die every day awaiting a liver transplant — 1,155 lives were lost last year. Until the wait list goes away, those of us involved in the nation’s donation and transplant system must strive to save more lives each year by reducing the number of patients who die while waiting. The new liver allocation policy will help by re-calibrating how geography is considered. Geography is part of the matching equation to ensure that we minimize the amount of time organs must be preserved. When the current distribution policy was developed 30 years ago, the arbitrary boundaries drawn around donor and transplant hospitals were less of a factor as there were fewer patients in need. Over time, differences began to emerge in patients’ chances of receiving a transplant in different regions of the country. The new policy restructures the outdated transplant map. Patients who are most in need and closest to the donor will get offers first. The new policy will treat equally sick patients the same. The matching process will be a simpler measure of distance from donor hospital to the transplant hospital, and it will continue the practice of prioritizing based on medical need. The gift of life should not be limited by arbitrary boundaries. Modeling predicts the new policy will result in about 100 fewer deaths each year, but even if it results in just one more life saved, it will be worth it.