LIVER TRANSPLANTS: Living Donor Procedure not Covered By Medi-Cal

      Although doctors have successfully performed adult-to-adult living donor liver transplants in the United States since 1991, Medi-Cal will not cover the surgery for most adults, the San Diego Union-Tribune reports. Currently, Medi-Cal covers live donor liver transplants for recipients ages 15 and younger and those weighing less than 80 pounds, because the procedure requires only a small portion of the adult donor's liver. However, Medi-Cal officials are wary about the safety of adult-to-adult procedures. Norma Arceo of the California Department of Health and Human Services said, "Right now [the procedure] is still in the investigational stages, and we want to make sure the procedure is safe for both the donor and recipient." Dr. Harvey Goldberg, Medi-Cal's medical consultant for benefits, added, "It's not quite proven that it is in fact beneficial and not too harmful to the donor." However, according to Dr. Tarek Hassanein, medical director of liver transplantation at the University of California-San Diego Medical Center, fewer than five donors have died in a few hundred live liver transplants performed in the United States. He added that Medi-Cal insures most of the 250 patients in his program, and as many as 20% will die this year waiting for a transplant. Goldberg said that Medi-Cal, which last updated its liver transplant rules in 1996, may consider approving the live donor adult-to-adult procedures next year. Meanwhile, Rep. Brian Bilbray (R-Calif.) questioned Medi-Cal's policy. He said, "It seems absurd that this kind of live donor transplant, which is really going to be the wave of the future, can't be done. Why would the state have an arbitrary barrier here?" (Branscomb, 8/20).