Organ Transplant Stakeholders Applaud OPTN Progress on Lifesaving Reforms to Liver Distribution for Transplant

At yesterday’s public meeting of the HHS-designated Organ Procurement and Transplantation Network (OPTN) Liver and Intestine Committee, board members and key stakeholders considered a variety of reforms that would reduce severe geographic disparities in organ distribution. 

May 8, 2017
For Immediate Release
Contact: Shea McCarthy, (202) 285-3866,
Yesterday, the Coalition for Organ Distribution Equity (CODE) applauded the OPTN Liver and Intestine Committee for moving forward with its deliberative, transparent process to address stark variations in liver access across the country, which is responsible for over one hundred avoidable waitlist-related deaths every year.
While stakeholders from parts of the country benefiting from disproportionately short wait times protest proposals that meaningfully address disparities, OPTN and its contractor, the United Network for Organ Sharing (UNOS), continue to move forward with well-developed, thoughtful concepts that will save lives.
At its meeting today in Chicago, OPTN formally reviewed analysis of proposals to adopt larger districts for broader organ sharing as well as newer “neighborhood” and “concentric circle” approaches that would achieve the same goal. OPTN also accepted extensive public comment on these issues at the event. At least one of the proposals will likely be posted online for written comments in late summer.
“Today the OPTN took another important step toward reforming our country’s liver distribution system,” said Harriet Melvin, CODE’s Executive Director. “We stand with patients across the country in support of evidence-based reforms that will reduce disparities in liver access that tragically cause unnecessary deaths every year, and look forward to providing constructive, substantive feedback when they are posted for public comment this summer.”
The proposals currently under consideration by OPTN/UNOS are over 22 years in the making.  In 1994, Congress reauthorized the National Organ Transplant Act (NOTA), clarifying that its intent “was to ensure patients that no matter who they were, or where they live, they would have a fair chance of receiving a necessary organ transplant.” In 1998, HRSA promulgated a Final Rule implementing NOTA, which highlighted existing geographic disparities and required implementation of policies “that provide organs to those with the greatest medical urgency… wherever they live.”
An initial OPTN/UNOS proposal to reduce the number of regions used for organ distribution was subject to public comment last year and CODE submitted extensive comments which highlighted the merits of the reform proposal. In those comments, CODE directly addressed the concerns of commenters who suggest that reforms would be a burden to communities which benefit from the current system.  “It is unproductive to speak in terms of the proposal rewarding one community over another,” the comment letter explained. “Federal policy dictates that organs for transplant are a resource to be distributed fairly across the entire country. Rather than rewarding one area at the expense of another, we believe this policy seeks to make sure that patients nationwide who are most in need will have a better chance of accessing organs for transplant no matter where they live.”
About CODE
The Coalition for Organ Distribution Equity (CODE) is a collection of stakeholders committed to improving patient access to organs for transplant. Consistent with the analysis published by the United Network for Organ Sharing (UNOS) in its concept paper titled Redesigning Liver Distribution to Reduce Variation in Access to Liver Transplantation, CODE advances policies that reduce geographic disparities in wait times, patient acuity at the time of transplant, and organ failure-related deaths. In doing so, CODE increases public and policymaker awareness regarding the current process governing organ distribution, its flaws, and how reforms can improve patient outcomes nationwide.