Liver Transplant Waiting Time Drops

[Guest guest]

05/14/00

Liver Transplant Waiting Time Drops

By LAURA MECKLER=

Associated Press Writer=

WASHINGTON (AP) _ The waiting time for the sickest liver

transplant patients was cut from five to three days after

transplant hospitals were required to send donated livers to the

sickest people rather than the closest patients, new research

finds.

But that came at a cost: Fewer patients with less-urgent

conditions got transplants.

The findings, which were being discussed at a transplant meeting

Sunday in Chicago, were expected. With a limited supply of donated

organs, any organ given to one patient is one taken away from

someone else.

Also, the research cannot quantify the impact of the change on

the relatively healthy patients because medical criteria changed

over time, making the numbers inconsistent, said the study's lead

author, Dr. Santiago Vera, who directs the liver transplant program

at the University of Tennessee in Memphis.

The change in liver allocation was ordered by the United Network

for Organ Sharing last summer. Normally, organs are first offered

to all patients in the local area before going to other

communities. But under the new policy, livers must be offered first

to any ``status 1'' patients within the region.

Status 1 patients are those who are suddenly struck by liver

disease and have a week or less to live.

This new policy brought the transplant network closer to the

philosophy of the Department of Health and Human Services, which

wants the network to break down these geographic barriers and get

more organs to the sickest patients.

The study presented Sunday involved the experience of Region 11,

comprised of Tennessee, Kentucky, Virginia, South Carolina and

North Carolina, or a total of 26 million people.

Vera and his colleagues set out to measure the impact of the

change.

The good news was reducing the waiting time for the sickest

patients by two days. ``That's a big deal,'' Vera said, with each

day critical for patients who are that ill.

But 132 of the less-sick patients _ those classified as status

2b or 3 _ died while waiting for a transplant.

Still, Vera had no way of knowing whether the number of deaths

in this group was higher or lower than in earlier years, given

changes in the medical classification over time. ``There's no way

to do that,'' he said.

--------------------------