The nation's transplant network is preparing a proposal to change liver distribution in favor of those who really need it, rather than basing it on the zip code. Once approved, it will increase the chance of people getting a liver transplant and decrease the possibility of dying while waiting.
The problem that patients have with the current policy is that the demand for some areas is high but the supply or donated organs from the same region is low. The sickest goes on top of the waiting list. Those who are less sick will need to travel to another region, say Ohio or Florida where there are more supply, so that they can get a transplant earlier. They will need to wait again and hope to survive until the day they get their chance for the liver transplant.
Such system is not helpful for most of the patients. A perfect example of a person who went through this process was the late Apple CEO Steve Jobs who had a liver transplant in 2009. He lives in California but had to travel to Tennessee where the waiting list was shorter. He could afford to travel that far and relocate while waiting because he has all the financial means to do so, but that is not the case for most patients.
Dr. Dorry Segev, a transplant surgeon from Johns Hopkins University and a liver specialists for the United Network for Organ Sharing, has an idea how to end this system. He describes the new proposal as "gerrymandering for the public good."
The term "gerrymandering" describes how lawmakers set political districts based on the party voting histories of different areas. Applying the process to liver transplant distribution will mean that all donated livers from 11 transplant regions will be pooled in, all patients regardless of their zip code will be assessed, then the sickest of all will get the first liver even if it is not from his zip code.
The proposal sounds logical enough but another problem that the network hasn't fixed is the shortage of livers. The network reported that they have only provided liver transplant to 6,256 patients last year out of 16,000 patients in the waiting list. Each year, 1,500 patients die waiting.
Segev's research team used computer remodeling to redistrict the 11 transplant regions and balance the supply to better meet the demand of liver. His analysis showed that 28 percent of high-risk patients were living in an area where the supply is low and redistricting could help decrease the rate to six percent.
The study was published in the American Journal of Transplantation.
Meanwhile, the network committee is already studying the proposal and thinking of other options as exporting the livers to farther regions is challenging. Another challenge is 'turf wars' because some transplant centers used to shorter waits are less likely to accept the idea that will need to wait longer since other regions are more high-risk than them.
