Posts Tagged ‘UNOS’

Proposed Redistricting for Liver Transplant Sharing Negatively Impacts Georgia and Southeast

liver-250x250A 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.

Changes to the UNOS Kidney Allocation System

Organ Donation Wait TimeThe Emory Transplant Center would like to share with our transplant community some important changes to the kidney allocation system managed by the United Network for Organ Sharing (UNOS). As many of you know, UNOS manages the nation’s organ transplant system and helps make the best use of donated organs. More specifically, the UNOS Kidney Committee had been meeting regularly to discuss an improved kidney allocation system which resulted in the UNOS Board of Directors approving a new kidney matching system that took effect on December 4, 2014.

Under the previous system, how long a person had undergone dialysis prior to being placed on the wait list did not count. But with this new system, it has changed.

“One of the major differences is that now you will be given credit for your dialysis time that will be added on to the time you’ve been on the waiting list,” says kidney transplant surgeon Dr. Nicole Turgeon of the Emory Kidney Transplant Program.

If you began dialysis before you were listed, your wait time will be backdated to the day you began dialysis. Dr. Turgeon says the new guidelines could really help many longtime dialysis patients.

Here are some important points to note with the new system:

  1. The time you spend waiting for a kidney is still a major factor in organ matching.
  2. You will not lose credit for any time you have already spent waiting.
  3. If you began dialysis or met the medical definition of kidney failure at the time you were listed for transplant, your waiting time will not change.
  4. If you began dialysis before you were listed for a kidney transplant, the time between beginning dialysis and being listed will be added to your waiting time.
  5. People who have the longest potential need for a transplanted organ and those who have been difficult to match under the current system will receive greater priority under the new system.
  6. The new system should provide more transplant opportunities, so that everyone has a better chance to be transplanted.

“It is big news for our patients. I think it’s really going to help them in terms of getting better access to transplants,” says Dr. Turgeon.

UNOS continues to monitor the system closely to make sure it is meeting the needs of patients. For more detailed information about the new kidney allocation system, visit the UNOS website at www.unos.org.

Emory Transplant Center Executive Director Elected to National Council by Peers

Dr. Thomas C. Pearson

Dr. Thomas C. Pearson

Thomas Pearson, MD, DPhil, executive director of the Emory Transplant Center, has been elected by organ donation professionals as incoming associate councillor of the Organ Procurement and Transplant Network and United Network for Organ Sharing (OPTN/UNOS) Region 3. Each of the 11 OPTN/UNOS regions has an associate councillor who serves as the regional representative to its national Membership and Professional Standards Committee. This committee oversees transplant community membership, policy and regulatory compliance and makes recommendations to the board regarding policy violations.

“Since 1991, Tom has been a valued friend and colleague at Emory and an esteemed transplant surgeon, bench and clinical researcher,” says Christian Larsen, MD, DPhil, dean of Emory University School of Medicine, former executive director of the Emory Transplant Center and a current kidney transplant surgeon. “But he also is internationally respected as a transplant immunologist, educator and transplant advocate, establishing many protocols in place today. He is perfectly suited to this role at OPTN/UNOS Region 3.”

Pearson, who is surgical director of the kidney transplant program at Emory and the Livingston Professor of Surgery, joined the Emory faculty in 1991. Together, with long time collaborator Larsen, they played a pivotal role in developing a new class of immunosuppressive drugs to replace the cyclosporine class of drugs and their major side effects and toxicities. The FDA approved the co-stimulation blocker called belatacept in June 2011 for kidney transplant recipients. This was the first time a new class of drug had been approved for transplant since the 1990s.

After Pearson’s term as associate councillor ends in 2016, he will assume the role of councillor for an additional two-year term of service (2016-2018), representing Region 3 on the OPTN/UNOS board of directors. Pearson also serves as medical director of LifeLink of Georgia, is a member of the Board of Governors for the LifeLink Foundation and is a board member of the American Society of Transplantation.