The federal government on Tuesday changed its system for distributing livers to transplant patients, likely meaning fewer livers and lower quality livers for patients in Georgia and some Midwestern states.
Now more livers are likely to go to patients in more populous states, such as New York.
Americans overall don’t donate enough livers for all the transplant patients who need them. So when a liver becomes available, a national computer system calculates which hospitals in which states and regions are offered the liver first.
Hospitals in some populous states such as New York believed that the previous distribution system was unfair. Many agreed that the geographic regions used in the system were antiquated. So the national organization that runs the computer system, the United Network for Organ Sharing, drew up a new distribution system, with new regions.
But Georgia and other states say the new system is also unfair. They sued.
The case is ongoing, but a federal judge ruled in January that in the meantime the government can make the switch. U.S. District Judge Amy Totenberg said she was not saying which system was right. But, she said, the government made a good enough argument for the moment that it drew up the change while working within the law.
Many issues are involved in the fight over what’s fair. The federal government said its policy is designed to save the most lives by getting livers to the sickest patients.
“This new policy will save more lives annually by providing more transplant access for the most urgent candidates,” UNOS said in a statement.
Plaintiffs say it’s faulty. They say the new calculations rely in part on how long a patient has been on a waiting list. They say that gives an advantage to patients with more abundant medical access who may get on waiting lists earlier in their sickness. Patients with scarcer medical access, such as those in rural Georgia, may not get on the list as soon as necessary.
One point that aggravated U.S. Sen. Roy Blunt of Missouri is that some of the areas that are now likely to receive many more livers have a terrible record at trying to get people to donate organs. The organ procurement organization in New York was so bad the government threatened to close it down.
“This is the wrong policy to implement and I will keep fighting it,” Blunt said in a written statement. “The new allocation policy rewards historically low-performing organ procurement organizations without taking steps to improve their performance and help more Americans receive a life-saving liver.”
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