WASHINGTON, D.C.-After nearly two years of debate, a proposal by the Department of Health and Human Services (HHS) to make organs available over a more widespread geographic area has gone into effect.
The final rule was implemented on March 16, at which time HHS issued a brief statement indicating that the rule "is an important element in ensuring that our organ transplant system will operate in the fairest and most medically effective way possible for the American people"
(www.hhs.gov/news/press/2000pres/20000316b.html). HHS had been trying to implement its rule for almost two years but met strong opposition from the transplant community, especially the United Network for Organ Sharing. UNOS operates the Organ Procurement and Transplantation Network (OPTN), which was told by HHS to develop new procedures for distributing organs that would favor giving organs to the sickest patients first regardless of geography; organs traditionally have been distributed first over narrow geographic regions governed by organ procurement organizations.
Just before the March 16 deadline, UNOS submitted a proposal to HHS that would make livers, specifically, available to the sickest patients across broader geographic areas than traditionally has been the practice (see Transplant News Network, March 1 and March 15, 2000). It is now up to HHS to consider the proposals submitted by UNOS. Livers have been at the heart of the ongoing debate because they are a particularly scarce organ.
In a March 16 letter to UNOS members posted at www.unos.org, UNOS president William D. Payne, MD, noted that "within one year, the OPTN shall examine all other organ-specific allocation policies in light of performance goals specified in the final rule….The relevant UNOS committees will soon begin this policy examination process, and I urge you to share your views and experiences to aid the committees and the UNOS Board in this process."
Less than a week after the new rule became effective, Reuters news service and the Associated Press reported that the state of Wisconsin has filed suit seeking to bar the federal government from implementing the new policy. Both news organizations said that Wisconsin has particularly high organ donor rates and could lose ground if its donated organs are sent elsewhere.
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