Tuesday
07Nov2006
Organ Rationing- Coming to a Transplant Center Near You
Tuesday, November 7, 2006 at 2:59PM
Scary stuff. The LA Times follows up last month's scathing critique of UNOS' lax oversight of the nation's transplant centers with a lengthy article detailing the capriciousness of UNOS' current organ allocation procedures.
UNOS, and the assorted transplant centers, have to make extraordinarily difficult decisions in determining who should receive available cadaver organs. Decisions that mean life or death to about 80 patients every single day. Multiple criteria are weighed: age, race, health, body mass index, diagnosis, years on dialysis. And then one lucky lottery winner is selected from more than 68,000 transplant ticket holders.
As the transplant waiting list continues to grow, the problems are getting worse:
The last line is key. The current system is headed for collapse. Is that a surprise? Of course not. The scope of this crisis has been predicted for years. Anyone who can read a line graph could have predicted this. And UNOS has done nothing substantive to respond to the escalating crisis.
The current system relies upon organs from deceased donors. There are simply not enough organs from deceased donors to go around. There never will be. We know that. UNOS knows that. Every transplant surgeon in the country knows that. So where does UNOS focus their efforts? Not on attracting living donors. Nope, that would be a logical and potentially effective strategy. Instead UNOS focuses all their increased efforts on attracting a diminishing number of organs from deceased donors.
Too old? Too bad. Waiting for four years? I hope you can make it to five. Got diabetes? Good luck to you. You'll need it.
UNOS, and the assorted transplant centers, have to make extraordinarily difficult decisions in determining who should receive available cadaver organs. Decisions that mean life or death to about 80 patients every single day. Multiple criteria are weighed: age, race, health, body mass index, diagnosis, years on dialysis. And then one lucky lottery winner is selected from more than 68,000 transplant ticket holders.
As the transplant waiting list continues to grow, the problems are getting worse:
Now the network is drafting a kidney allocation scheme for adults, who account for more than 95% of transplants using kidneys from cadavers. A formal proposal and public hearings are expected next year. The final decision will rest with the U.S. Health Resources and Services Administration.
The reexamination is largely based on a computer analysis of data on more than 300,000 patients placed on kidney waiting lists since 1987 — including age, race, health, body mass index, diagnosis, years on dialysis and years of survival after transplant.
The analysis shows which types of recipients should be favored in order to squeeze the maximum life out of the pool of all available kidneys.
Without a change, proponents say, the current system is headed for collapse.
The last line is key. The current system is headed for collapse. Is that a surprise? Of course not. The scope of this crisis has been predicted for years. Anyone who can read a line graph could have predicted this. And UNOS has done nothing substantive to respond to the escalating crisis.
The current system relies upon organs from deceased donors. There are simply not enough organs from deceased donors to go around. There never will be. We know that. UNOS knows that. Every transplant surgeon in the country knows that. So where does UNOS focus their efforts? Not on attracting living donors. Nope, that would be a logical and potentially effective strategy. Instead UNOS focuses all their increased efforts on attracting a diminishing number of organs from deceased donors.
Too old? Too bad. Waiting for four years? I hope you can make it to five. Got diabetes? Good luck to you. You'll need it.
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