The Greater New York Hospital Association (GNYHA), recently submitted a comment on the United Network for Organ Sharing (UNOS) and the Organ Procurement and Transplantation Network (OPTN) Liver and Intestinal Organ Transplantation Committee’s (Committee) proposal for Enhancing Liver Distribution. In the comment letter, GNYHA specifically addresses the continuing disparity that leads to higher overall death rates where patients wait longer for life saving transplants. "Patients who wait longer have a higher chance of dying after transplant. In geographically disadvantaged areas, the detriment of waiting has been high, lowering a candidate’s chances of survival both before and after transplant," the comment letter states. "Every transplant candidate should have an equal chance to receive a lifesaving organ transplant because donated organs are a shared national resource. Equitable transplantable organ distribution cannot be achieved while patients in some places continue to wait longer, get sicker, or die before they can receive a transplant."
The Coalition for Organ Distribution Equity submitted a letter to the Organ Procurement and Transplantation Network (OPTN) United Network for Organ Sharing (UNOS), commenting on the OPTN/UNOS Liver and Intestinal Organ Transplantation Committee’s (Committee) proposal for public comment: Redesigning Liver Distribution. "We applaud the Committee’s hard work to address the difficult problem of equitable distribution for the current supply of livers for transplant in the U.S.," CODE writes. "The policy encompassed within the proposal will bring tremendous benefit to the thousands of patients who suffer due to the current inequitable distribution scheme. As an organization dedicated to equity in liver distribution, CODE supports the policy as written, encourages its expeditious finalization, and looks forward working with the Committee toward successful implementation."
This statement from the Chair of the OPTN/UNOS Liver and Intestinal Organ Transplantation Committee summarizes comments delivered by participants at the September 16, 2014, open forum for responses to the UNOS Concept Paper. The Chair commits to further studying and refining the metrics and other inputs used to generate the alternative models presented in the paper and to welcoming public comment going forward.
In this paper, released in June 2014, the Organ Procurement and Transplantation Network (OPTN)/United Network for Organ Sharing (UNOS) Liver and Intestinal Organ Transplantation Committee identifies the considerable geographic disparities in organ access that exist across the country at present. UNOS references a long history of inquiry, research and public comment, dating prior to a March 2000 final regulation from HRSA, through Institute of Medicine (IOM) recommendations and Department of Health and Human Services (HHS) advisory committees, that preceded the analysis presented in its paper. Ultimately, UNOS compares the present system to one where the nation is divided into four or eight districts for organ distribution, noting that these could drastically reduce the average acuity of patient organ failure at the time of transplant and save over 500 lives over five years.