Sunday, January 16, 2000

Centers join transplant coalition

Members reject sickest-first rule

The Cincinnati Enquirer

        The Health Alliance of Greater Cincinnati and Children's Hospital Medical Center have joined a coalition of 15 transplant centers that plans to fight proposed reforms of federal organ supply policy.

        The Coalition of Major Transplant Centers includes Ohio State University, the University of Alabama-Birmingham, the University Medical Center of Minneapolis and the University of Wisconsin — four of the nation's eight largest transplant centers.

        “There's a perspective out there that (opponents to reform) are only small transplant centers concerned about shutting their doors. That's not true. The centers that are concerned about these proposed changes are major centers,” said Dr. Douglas Hanto, liver transplant surgeon at University Hospital, which does most of the organ transplants at the Health Alliance.

        For the past few years, interest groups have debated who should be first for the constantly short supply of donated organs, especially livers. A new federal policy would have taken effect in 1998, but was delayed by court action and by Congress. The latest moratorium ends in March.

        The current system is run by a non-governmental medical agency called the United Network for Organ Sharing. Under UNOS rules, when a donated organ becomes available in a local region (ours includes Ohio, Indiana and Michigan) the sickest person in that region gets priority before the organ becomes available on a nationwide basis.

        As a result, a local patient can get a locally donated organ even though sicker patients in other regions have been on waiting lists for longer times.

        Claiming that such a system is unfair, some patient groups and several very large transplant centers led by the University of Pittsburgh convinced the U.S. Department of Health and Human Services to propose a sickest-patient-first policy.

        Basically, the new coalition wants Congress, the Clinton administration and the public to know that many other large transplant centers do not believe deep changes are needed in the organ sharing system.

        “We believe that most of the major transplant programs across our country have a similar perspective on the critical issues ... but this perspective has been overshadowed by the loud voices of a couple of large centers with a different agenda,” said Dr. Hans Sollinger of the University of Wisconsin, a coalition co-founder.


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