Wednesday, September 17, 2014

Doctors react to UNOS Hearings on liver re-allocation

KANSAS CITY, KAN. – Hundreds of concerned members of the transplant community from across the nation packed the room at a Chicago hotel today while many more listened via a live streamed webinar during a passionate day-long public forum about liver re-allocation.

United Network of Organ Sharing (UNOS) hosted the forum to discuss its re-allocation plan to take donor livers from areas with the highest donation rate and give to patients in the lowest donation areas.

Supporters believed the plan would save more lives, but those against broader sharing said the analytics presented by experts did not fully support those claims. UNOS Liver and Intestine committee members heard from both sides in a discussion that was lively and at times highly divided.

“There is strong opposition to the redistricting plan presented today,” Tim Schmitt, MD, director of transplantation at The University of Kansas Hospital said. “There is no evidence presented today showing more lives would be saved through redistricting, but plenty of concern that broader sharing would further limit access to minorities and  patients in small towns.” Schmitt said. Dr. Schmitt attended the public hearing along with Sean Kumer, MD, surgical director of transplantation at The University of Kansas Hospital.

“The new proposed allocation algorithm with all of its complexity and time involved has basically proven that we will still continue to transplant the same 6,000 livers with no change in waitlist mortality,” Dr. Kumer said.

Attendees against broader sharing called on UNOS to put more efforts and expectations on increasing organ donation and delay plans to dramatically change liver allocation.

Both sides agreed more collaboration is needed among transplant programs, Organ Procurement Organizations (OPO’s) and others to work on increasing organ donation in all communities and making the best use of a scarce resource.  No action was taken during the hearing or expected in November when the full UNOS board meets according to UNOS Vice President Carl Berg, MD.

“There is good news from today’s proceedings,” Dr. Schmitt said. “The models presented showed 500 lives could be saved over 5 years through broader sharing, but if other regions increased their donation rate to match the Midwest … we could save 5,000 lives.”

Organ awareness and donation is the true solution said both doctors and several other presenters and attendees.