Liver Transplant Waiting Time Drops

Monday, May 15th 2000, 12:00 am
By: News On 6

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.