ORGAN ALLOCATION: UNOS Agrees to Need-Based System
The United Network for Organ Sharing ( UNOS) yesterday came a "step closer" to ending a two-year- long dispute with HHS over the nation's organ allocation system when the organization agreed to "expand the geographic areas that guide allocation decision" allowing organs to travel further to reach the sickest patients, the AP/Worcester Telegram & Gazette reports. Under current rules, organ allocation is based more on proximity than patient need. UNOS also agreed to develop a new system to rank patients on waiting lists. Under the proposed system, rankings would be based on "a sophisticated, objective point system," with points given based on symptoms. Patients with the most points would be placed at the top of the list.
The Waiting Game
Currently, UNOS uses a system that places patients in one of four groups, with the length of time spent on the list determining which patient receives an organ. While the new system will evaluate waiting times, they will play a less significant role in determining allocation. Wanting to create a more equitable system, HHS ordered UNOS to create a new system giving preference to the neediest patients. UNOS and some transplant centers balked at the plan, arguing that more locally donated organs would end up going to patients at larger centers with more of the sicker patients. They contended the HHS lacks the authority to change the rules, and Congress twice put a hold on the regulations. With the last moratorium set to expire and Congress poised to take no further action, UNOS convened a special board meeting in Dallas and approved the agreement. UNOS officials pointed out that the new plan was reached after both sides made compromises. In October, HHS revised the regulations to clarify that organs need not be shipped from coast to coast, and stipulated that organs should not be given to "dying patients too sick to benefit" (3/14).