The science of organ transplantation has run headlong into the politics of a network that no longer recognizes regional distribution. Senators from Missouri and Kansas, states with a high percentage of donors but a lessening number of available organs, have taken notice.
Earlier protests by Sen. Roy Blunt, a Missouri Republican, and Sen. Jerry Moran, a Kansas Republican, went unheeded as a distribution system based on “acuity circles” went into effect on Feb. 4.
Blunt, who chairs the appropriations committee that oversees the Health and Human Services Department, calls the new organ allocation policy “terribly flawed.”
The United Network for Organ Sharing, a nonprofit organization that coordinates transplants, contends the new policy prioritizes adult deceased donors for suitable candidates within a 500-mile radius of the donor hospital.
It replaces a procedure that depended on a donation service area and regional boundaries. The new policy had been approved in 2018, but court challenges had suppressed its full implementation. A federal court ruling last month lifted the remaining delays.
Blunt and Moran contend the policy punishes largely rural areas, where the idea of neighbors helping neighbors has an appeal.
“In Missouri, 73% of people are organ donors or at least willing to be organ donors. In New York, for example, 32% of people are organ donors,” Blunt said on the Senate floor.
“You will no longer know, if you are an organ donor, that the people who live closest to you have the greatest chance of getting that organ that you have been willing to donate.”
The Missourian said last year that 32% fewer organs for transplant would be available in his state, in which Washington University and Barnes Hospital are leading stakeholders in medical transplants.
Moran said the University of Kansas performed as many as 10 liver transplants a month before the policy change.
“Current estimates are at KU, the hospital, it may take up to six months before they are able to provide another one of these lifesaving organ donation operations,” the Kansan said in a Senate speech. “Meanwhile, those on the transplant list in Kansas watch their wait times grow as hope begins to dwindle.”
Brian Shepard, CEO for the United Network for Organ Sharing, hailed the new policy after it cleared the judicial hurdle last month.
“The new policy improves upon the previous system to make it fairer by providing more equitable access to a transplant for the benefit of all patients based on medical need,” he said. “Over time the prior system developed geographic disparities and addressing these problems emerged as a top priority.”
According to his organization, 112,444 patients resided on American organ transplant waiting lists during 2019, with 39,717 transplants being performed.
Kidney transplants were most frequent, with 23,401 in 2019, with livers next at 8,896 and then hearts at 3,551.