ORGAN ALLOCATION: Children Vs. Adults?
Today's Los Angeles Times looks at the debate over whether the nation's organ allocation system "is unfair to children." Diane Jones, a Maryland woman whose 4-year-old daughter needs a liver transplant, contended that the current system "pits growing children ... against elderly, often sicker patients," adding: "There are people who have, through their own knowing conduct, abused their bodies through drugs or alcohol ... and are competing with our innocent children for these precious livers. Our children are not sick because of anything they have done." Johns Hopkins Medical School's Dr. Paul Colombani said, "Pediatric patients can't live long enough on a waiting list to get high enough and compete with adults, and nothing has really been done to address that." Data from the United Network for Organ Sharing show that 8.7% of children on organ waiting lists died last year, compared to 5.6% of adults. Furthermore, a Medical University of South Carolina study, conducted with UNOS, "showed that, while the number of pediatric liver donors increased from 800 in 1990 to 936 in 1996, the number of children who have received a donated liver from another child decreased from 379 in 1990 to 306 in 1996." Colombani noted that doctors "are now using organs from donors as young as 8 for 50- to 60-year-old recipients."
Will The Gov't's Plan Help?
The Times notes that the Clinton administration's proposed rules to revamp the organ sharing system "made no mention of special treatment for children, an omission that worries many within the pediatric transplant community who believe that children should be dealt with separately." Though some parents supported the administration proposal -- which would ensure that organs go to the sickest patients first, regardless of geographic location -- others questioned whether a national list would really benefit children. They argue that children -- "because they are young and often otherwise healthy -- often represent the best opportunity for long-term survival." UCLA Medical Center's Dr. Sue McDiarmid said, "The problem that we worry about with a national list is that if you will always transplant the sickest person first, you will end up transplanting some people who will die." She added, "Utility would say put the organ where it will do the most good for the longest period of time" (Cimons, 11/9).