ORGAN ALLOCATION: RAND Declines to Run National System

      Santa Monica, CA-based RAND Corp. Monday withdrew from discussions to operate the nation's transplant system, leaving the system's current contractor, Richmond, VA-based United Network for Organ Sharing (UNOS), as the only viable transplant regulator, the AP/San Francisco Chronicle reports. In a letter to HHS, the private research group lamented that the "dicey politics" and "tension surrounding transplant policy would make it very difficult to operate the system," claiming, "In the current environment, it would be difficult for any contractor to avoid being perceived as a new combatant in an ongoing power struggle." The move comes as a blow to HHS officials, who are battling UNOS and Congress to replace the current geography-based transplant system with one based on medical need. The agency and supporters viewed RAND's interest in running the system as an opportunity to contract with a "much friendlier" group and "had hoped ... [it] would put pressure on UNOS to work more closely with HHS." RAND researchers indicated that they still would like to assist in engendering a "national consensus on the basic principles and structure for transplantation policy-making." Although HHS officials refused to comment on the matter, allies of the need-based system were "disappointed." National Transplant Action Committee Director Charles Fiske said, "The current system really is held captive by the current contract holder. Competition is a good thing in this particular area" (Meckler, 12/1).