Editorial: Transplant organs need a fairer distribution in U.S.

By The Herald Editorial Board

The organ transplant disparity was always there, but the late Steve Jobs’ case brought it fully into the light.

This month, the nation’s largest transplant network implemented steps to ensure fairness for those seeking a transplant regardless of where they live. The problem has always been that some areas of the country have fewer available organs and a higher demand for them than others, the Associated Press reported. Highly populous places, such as California and New York are among the toughest places to get a new liver, AP reported, compared to South Carolina or Washington state.

In Jobs’ case, the Apple CEO in 2009 was able to list himself in California, and also Tennessee, which at the time had one of the country’s shortest waiting list, and where he eventually received his liver transplant. Getting on several waiting lists is legal, but it’s a move obviously available only to those who can afford do so, and who are aware it can be done.

Earlier this month, the United Network for Organ Sharing proposed redrawing the map that governs how donated livers are distributed so patients wouldn’t need to leave home for better odds, according to the AP.

“We want to make sure we give everyone a fair opportunity to get a liver transplant,” said Dr. Ryutaro Hirose, chairman of the liver transplant committee at UNOS, which runs the nation’s transplant system. “It’s pretty much long overdue.”

Livers are offered to sickest patients first, as determined by a ranking, but the nation’s 11 transplant regions are subdivided into local areas with individual waiting lists, and there are wide variations in organ availability both within and among regions. The revised plan calls for dividing the nation into eight districts, which would allow wider sharing and shift the boundaries to better mix areas where more potential donors live with areas that have longer waiting lists. The goal is to have patients with similar illness rankings at the time of transplant, regardless of where they live, to get organs to those with the greatest immediate need.

Currently, more than 14,600 people are on the waiting list for a new liver. Just over 7,100 received one last year — all but a few hundred from deceased donors — and more than 1,400 people died waiting, the AP reported.

“The distribution of organs is not a right, it’s a gift. We want to try to allocate that gift in the most fair way possible, the way that does the greatest good,” said Dr. Abhinav Humar of the University of Pittsburgh Medical Center, in response to the proposed change.

Some good news also accompanies this needed change in organ distribution (not just livers) — organ transplants in 2015 exceeded 30,000 for the first time annually, a 4.9 percent increase over 2014, and continuing a three-year trend, according to the Organ Procurement and Transplantation Network. An average of 22 people die daily while waiting for transplants. Almost 60 percent of transplanted organs in the United States are kidneys, and the vast majority of people on waiting lists need that organ.

Approximately 81 percent of the transplants (24,982) involved organs from deceased donors, who can donate multiple organs. Nineteen percent (5,986) were made possible by living donors. This last number is important — especially with the demand for livers. Because a piece of a liver can regrow, patients can avoid the transplant wait if they’re able to find a living donor.

More organ donors are always needed, and social media sites like Facebook have made it easier for people to make their wishes known. People must, however, sign up through their state to be legal organ donors. According to the White House, while 95 percent of the public supports organ donation, only 50 percent are registered as donors, the Washington Post reported. In June, the White House joined a group of universities, companies and nonprofits that announced new steps to reduce the wait time for an organ transplant, including a $160 million Pentagon program to develop ways to repair and replace cells and tissue.

All these efforts are good starts. Sign up today to be an organ donor and be part of the solution.

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