Modified organ rules go into effect allocating livers to sickest patients first

March 16, 2000
Web posted at: 2:13 PM EST (1913 GMT)

By Peter Hartogs

WASHINGTON (CNN) -- New regulations giving patients access to livers from a wider geographical area have gone into effect. The guidelines end nearly two years of battle between Congress and Health and Human Services Secretary Donna Shalala over how to distribute organs for transplant.

A moratorium imposed by Congress lifted Thursday, allowing the new regulations.

Last year about 5,000 people died waiting for organs. About 1,200 of those were waiting for a liver. More than 68,000 people are now waiting for organs; of them, 15,000 for a liver.

The organs are distributed through 11 large regions ranging in population from 1 to 12 million people. When a liver becomes available, it is offered first to the patients in that region even though there may be a sicker patient in the neighboring region. The new regulations expand the regions for livers, making them available for the sickest first in a wider area.

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Critics of the sickest- first proposal said regions were necessary, because in some cases an organ can only live outside the body for a short period of time; not long enough to fly the organ across the country.

The regulations have been disputed since first proposed by Shalala in April of 1998.

In October of 1998, Congress imposed a year-long moratorium on the regulations, to allow time for an independent study by the Institute of Medicine. The report was published in July of last year and supported Shalala's regulations for allocating organs across wider areas to the sickest patients first.

Although these regulations are for livers, policies will be drawn up for other organs.

The United Network for Organ Sharing is responsible for the nation's organ distribution. On Monday, the network board of directors approved an allocation plan that officials said furthered the goal of "fair and equitable organ distribution." Implementation of the new rules won't occur for several months, officials said.

The plan calls not only for wider regional sharing, but development of objective criteria for listing patients properly.

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United Network for Organ Sharing (UNOS)
U.S. Department of Health and Human Services

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