RICHMOND, Va.- In anticipation of enactment of a Department of Health and Human Services (HHS) mandate to change the way organs are distributed in the United States, the United Network for Organ Sharing (UNOS) has developed a new plan for the distribution of livers.
For almost two years, HHS has been trying to implement rules that would put medical need ahead of geography when determining priority for organs. Fighting between the government and the transplant community has caused implementation of the rules to be delayed a number of times. The latest moratorium is set to expire on March 16, the same day that UNOS's new plan is due at HHS.
The plan proposes a new way to distribute livers that moves away from the traditional geography-based system and toward the way the government wants it. The board of directors of UNOS expects to consider the proposal on March 13 in Dallas before submitting it to HHS.
"The development plan is intended to further the goal of fair and equitable distribution of donor livers nationwide," UNOS said in a statement.
The plan proposes that to determine priority for livers among status 2B and status 3 patients-those who have less dire need for a liver-a numerical scale should be developed that would place more emphasis on the patient's medical condition than on how long the patient has been waiting for a new liver. Numerical scales also would be used to predict mortality and thereby "to discourage liver transplantation when the probability of success is so low as to constitute an inappropriate use of a scarce lifesaving resource," the plan says. The plan also calls for broadening the geographic areas over which livers are allocated.
UNOS has further clarified its position on the pending regulations in a February 21 letter that UNOS president William D. Payne, MD, sent to the Health Resources and Services Administration.
For Your Information:
For a link to the new UNOS proposal, click on "Comments Sought on UNOS Liver Allocation Plan" on the right-hand side of UNOS's homepage at www.unos.org.
For a copy of Dr. Payne's letter, click on "UNOS Comments on Revised Final Rule" at the homepage.
Also see related story, "Opposition to Allocation Rules Continues."
Please be aware that medical advice, diagnoses and physician references cannot be obtained from this site.