The Department of Health and Human Services (HHS) has published amendments to its Final Rule changing the way that organs are to be distributed in the United States.
The amended regulations, which are expected to become effective in late November, respond to concerns that the transplant community has voiced over the past year and a half since the HHS announced its intention to take greater control over national transplantation policy.
While organs traditionally have been offered first to patients in the local area in which they become available before being offered over broader geographical regions, the HHS has said that organs should be distributed to the sickest patients first — regardless of where they live in the United States. Much of the transplant community has rejected that notion, complaining that such a system would shut down smaller transplant programs.
The amended regulations, however, specify that there should be no single, nationwide waiting list for organs. Instead, the rules less specifically call for "medically appropriate broader sharing of organs," the HHS said.
The revised rules also call for the establishment of an independent advisory committee composed, in part, of transplant physicians to help HHS oversee the policies of the Organ Procurement and Transplantation Network (OPTN).
The American Society of Transplant Surgeons (ASTS) responded, however, that the amended rules still give the government too much say in medical issues. "The bottom line is that the Secretary [of HHS] continues to insist on having the final word on decisions related to the allocation of organs to transplant patients," said ASTS president Ronald W. Busuttil, MD, PhD. "We absolutely believe the Secretary should exercise oversight over the OPTN, but we do not believe the Secretary should be making medical decisions."
Ironically, the new measures by HHS come at a time when the House is considering legislation that would strip HHS of much of its power over transplantation issues (see Transplant News Network, October 15, 1999).
For Your Information:
HHS - HRSA Division of Transplantation
the new amendment, news releases, and background information
http://www.hrsa.dhhs.gov/osp/dot/ASTS news release
http://www.asts.org/publicpolicy/101899_a.htm
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