Widespread local access to liver transplant centers is a myth, according to a report released in August by the Office of Inspector General of the Department of Health and Human Services (HHS).
Regulations by HHS are expected to go into effect in October that would put medical urgency ahead of geography in determining the eligibility for organs. The proposal has met with much resistance, however, with some detractors saying it is advantageous for patients to receive a transplant at a local center.
The new report has found, though, that it is not true that there is widespread local access to a transplant center. "For many patients, such access does not, in fact, exist," the office of Inspector General June Gibbs Brown said.
The report, which focused on liver transplantation because livers have been at the center of the debate, found that the 117 liver transplant centers in the United States in 1997 were located around major metropolitan areas. In 1997, 77 of the centers were in cities having at least two liver transplant centers, and more than 80% of liver transplants were performed in 35 cities. This geographic distribution "leaves large portions of the United States population at considerable distance from a transplant center," says the executive summary of the report.
Also in 1997, 45% of Americans lived outside the metropolitan areas that had liver transplant centers, 15 states had no liver transplant centers, and 20 transplant centers — in 18 cities — performed more than half of all liver transplants.
For Your Information:
HHS Office of the Inspector General / Office of Evaluation and Inspections
Inspection Report: Fostering Equity in Patient Access to Transplantation — Local Access to Liver Transplantation (OEI-01-99-00470; 8/99)
PDF: http://www.dhhs.gov/progorg/oei/reports/a400.pdf
HTML: http://www.dhhs.gov/progorg/oei/reports/oei-01-99-00470.htm
Word Perfect: http://www.dhhs.gov/progorg/oei/reports/oei-01-99-00470.wpd
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