A proposed redistricting policy in the regional structure for liver transplant distribution may have a negative impact on the state of Georgia and the region.
Currently, the demand for liver transplants exceeds the supply of liver donations nationwide, and many patients with liver disease will die while on the waitlist to have this life-saving surgery. To decrease the disparity in wait times for liver transplantation in the U.S., the United Network for Organ Sharing (UNOS), with the support of the Scientific Registry of Transplant Recipients (SRTR), is proposing to change the current liver allocation distribution. This plan proposes to share donor organs more broadly in an attempt to reduce geographic disparities.
But experts at the Emory Transplant Center say the proposed changes would:
- Drive up costs.
- Decrease survival rates.
- Lower the quality of donated organs because of a longer travel time to the intended recipient.
- Extend the recovery period for the patient.
- Exacerbate disparities in health care suffered by minority and rural communities.
The Southeast already faces substantial health-related disparities, including less insured patients, fewer available doctors and higher rates of liver disease overall.
The proposed redistricting will take organs from the South, which already has multiple barriers to liver disease care for minority, low-income, and rural patients, and send them to the Northeast, which has a much higher rate of listing liver disease patients.
Currently, the U.S. is divided into 11 regions. Georgia is in Region 3 along with Alabama, Arkansas, Florida, Louisiana, Mississippi and Puerto Rico. Within Region 3, livers are shared across state lines for patients with a MELD (Model of End Stage Liver Disease) score greater than or equal to 35. A MELD score is used to determine a patient’s place on the liver transplant waiting list. A higher MELD score means a higher mortality rate. Because some patients’ disease is poorly reflected by MELD alone, they may be granted an “exception score” to make them competitive for organs. Certain regions, however, grant these exceptions more freely, so that patients’ average scores at transplant may differ greatly between regions.
The new proposal would change the 11 regions to eight districts, with Georgia in District 1. The new district would expand up the Atlantic Coastline and include South Carolina, North Carolina, Virginia, Washington, DC, Maryland, Delaware, New Jersey, New York, Connecticut, Rhode Island, Massachusetts, New Hampshire, Maine, as well as Puerto Rico. Within this district, livers would be shared across state lines for patients with MELD scores equal to or greater than 29.
We feel the new proposal will have a negative impact on patients waiting for liver transplants in Georgia and across the Southeast. Emory prides itself on our commitment to our patients. In transplant, this commitment includes a dedication to maintaining availability of donor livers for patients most in need. For more information about liver transplants in Georgia and the Southeast and what you can do to help, visit the Collaboration for Donation Fairness website.