ORGAN DISTRIBUTION: New Plan Could Benefit Bay Area Significantly

      The Bay Area could stand to gain the most from the Clinton Administration's proposed transplant distribution overhaul, the San Jose Mercury News reports. Currently, the area's residents have the nation's longest wait for organs -- an average of 3 1/2 years for a kidney -- twice the national average. Experts blame the long Bay wait in part to "the presence of world-class transplant centers such as UCSF Stanford Health Care Center," which attracts "recipients from all over the globe, yet donations come exclusively from local residents." But the Clinton policy shifts the focus "from geography to medical need," attempting to "help the sickest patients first, wherever they live." The new system will increase organ access to patients in need and may indirectly benefit minorities who "have higher incidence of diseases, such as hypertension and diabetes," making them among the sickest on waiting lists.

Old v. New
      Under the previous distribution rule, "when an organ became available, it was offered to the sickest people in an area initially determined by population." If a local patient did not need the organ, it would be offered regionally, then nationally. Under the new plan, the "most medically urgent patients" will be considered first, but the distribution area will be "as broad a geographic area as feasible." But at least five state legislatures have adopted laws "intended to block the effort by the Clinton administration to broaden the organ distribution network." Also in opposition is the United Network for Organ Sharing (UNOS) which operates the transplant system and supervises regional operations. UNOS argues that the allocation of organs should be determined by medical experts only.

Arguing Over Nothing?
      The Mercury News reports that over 65,145 Americans, more than at any previous time, are hoping to receive organs, while only 10,073 organs were donated last year. Transplant experts cite "seat-belt laws, anti-drunken driving legislation, handgun control and a shortage of nurses to preserve the organs of brain-dead patients," along with "lack of awareness, religious concerns and a distrust of doctors" by minorities as reasons for the organ shortage. Dr. Oscar Salvatierra, architect of the National Organ Transplant Act of 1984, feels that "[o]rgan distribution is a minor point" when compared with the shortage in donated organs (Krieger, 10/20).