American Medical News‘ Kevin O’Reilly writes that, spurred on by attention paid to Apple boss Steve Jobs’ trip to Tennessee to take advantage of shorter liver transplant waiting lists, the United Network for Organ Sharing (which has a government contract to run the country’s Organ Procurement and Transplantation Network) will meet in the spring of 2010 to address socioeconomic and regional variations in access to donated organs (see a graph of regional waiting list sizes here).
Photo by futureatlas.com via Flickr
Jobs did not break any rules, experts say, but he did use his resources to take advantage of an imperfect system. One of the biggest problems? Multiple listings, in which one wealthy patient hops on waiting lists across the country and plays the odds to get the fastest-possible transplant. In what may be an obstacle to reform, some argue that multiple listing is a reasonable practice used by rich and poor alike. Additionally, others say that regional differences in transplant wait times reflect more than just differences in access to health care; they also reflect the high cost of transporting live organs and differing regional success rates in encouraging new donors and standards for harvesting organs.
- In a package for the Los Angeles Times, Charles Ornstein and Tracy Weber looked at UNOS oversight failures and what distinguished the best organ transplant centers from their less-successful peers. Here, the duo tell AHCJ members how they put the project together (includes tips on accessing and using UNOS and other transplant data).
- GAO report on correcting deficiencies at transplant oversight agencies
Multiple listings is not a ‘loophole’. UNOS allows multiple listings because they are paid a fee (over $500) for every recipient added to the waiting list, even if it’s the same individual 20 times. The ‘regional’ disparities are a result of two things: the decreased quality of donor organs the longer they are ‘on ice’ (aka, the sooner they can be transplanted, the better) and B. the transplant centers and surgeons’ opposition to ‘sharing’ donor organs with other centers and thereby not being paid the $400,000-$500,000 they charge for each transplant. As with most ‘issues’, this one is mostly motivated by money.