Vanderbilt Fights Policy That Could Result In Fewer Liver Transplants For Tennesseans | Nashville Public Radio

Vanderbilt Fights Policy That Could Result In Fewer Liver Transplants For Tennesseans

Sep 12, 2016

Traci Corrigan of Clarksville has been waiting for a call since April when she was diagnosed with autoimmune disease. This 49-year-old mother of two needs a new liver. So she hasn't left town. And her cell phone is always charged.

"You carry it with you when you go into the bathroom," she says. "You carry it with you when you are in the shower, so at least you can read and see who it is from."

The call came over the weekend. In less than six months, Corrigan went from joining the transplant list to receiving a new liver on Saturday at Vanderbilt University Medical Center. In part, the relative speed is based on her geography.

Tennessee is a place with such healthy organ donation rates that Apple founder Steve Jobs bought a home in Memphis when he needed a liver so he could be double listed in Tennessee and California, where patients tend to wait longer for a donor.

Vanderbilt University Medical Center, which performs the most transplants in Tennessee, even touts the fact that the state is a good place for transplant patients in a promotional video.

So Vanderbilt is protesting a proposal to rework the nation's system for determining who gets a liver transplant. The hospital says the result would be fewer livers for Tennesseans.

Currently, a Tennessee patient gets first dibs on a Tennessee liver. Then there's a sequence of offering it to some neighboring states and then anywhere in the nation.

But the agency that governs organ transplants — the United Network of Organ Sharing (UNOS) — says it shouldn't matter where a patient lives. The proposal, which was intended to increase fairness, would move away from local priority, meaning New York and California — which have lower rates of donation — would be net recipients of livers from places with higher donation rates.

Vanderbilt claims that because of one-on-one counseling with the families of dying patients, 95 percent of them agree to donate the organs of their loved one.

Seth Karp, who chairs the Vanderbilt Department of Surgery, argues UNOS should not "redistribute" organs to places like New York, which have a 53 percent donation rate.

"Local efforts in the community have been very successful in increasing the number of donors," Karp says. "If this system were to go through, then the local communities would have very little incentive."

Karp also believes the redesign could become a logistical headache, with organs regularly being flown hundreds of miles to reach a recipient. A liver from Tennessee, for instance, could easily wind up in Chicago.

The new plan includes eight districts, shown here in a draft of the proposal.
Credit UNOS

UNOS sees this map as more fair. 

"This proposal seeks to modify these boundaries to better match organ supply with demand, ensuring more equitable access for those in need of liver transplant regardless of their place of residence or listing," the proposal states.

The change is up for public comment through mid-October.