Under New Law, Kidney Transplant Priorities Will Shift

Editor's Choice
Main Category: Transplants / Organ Donations
Article Date: 25 Feb 2011 - 11:00 PDT

Current ratings for:
'Under New Law, Kidney Transplant Priorities Will Shift'

Patient / Public:4 stars

3.95 (20 votes)

Healthcare Prof:5 stars

4.57 (7 votes)

Article opinions: 23 posts

If the new changes pass to the transplant recipient list priorities, organs will be allocated to those who are expected to live longest and to individuals who are within 15 years of the age of the donor. Only around 17,000 Americans actually receive the required transplant they need each year, and nearly 5,000 people die waiting for their transplant.

The current established policy disregards age and health status, and only accounts for where the patient is in line, which right now is approximately a 70,000 name list, with over 110,000 on the waiting list.

The nation's organ transplant network is proposing that patients and transplant kidneys be graded and separated into groups. The healthiest and youngest 20% of patients and kidneys would be segregated into a separate pool so that the best kidneys would be given to patients with the longest life expectancies. However, the remaining 80% of patients would be separated into groups that would limit the age difference between the patient and the organ to 15 years or under. For example, someone who is 60 could only get a donor kidney from someone age 45 to 75.

The principle is used during extreme danger would now apply, meaning resources are allocated to those who are most likely to survive. These new proposed changes are believed to be an improvement, as someone expecting to live just 10 more years, does not need an organ that can adequately function for 40 years or more.

The United Network for Organ Sharing (UNOS) is charged with the difficult task of organ transplant management. When organs are donated, a complex process begins. UNOS maintains a centralized computer network which links all organ procurement organizations (OPOs) and transplant centers. Transplant professionals can access this computer network 24 hours a day, seven days a week.

Every day, the Organ Center handles at least 350 requests from transplant organizations for organ placement assistance, waiting list modifications, policy information and organ transportation assistance.

In the United States, nearly 90,000 men, women and children are waiting for kidney transplants for example. Potential recepient's struggle to live depends on a complex and technologically advanced organ allocation system that links patients with organs donated by strangers. The nation's organ-transplant network is considering a change in their Kidney Transplant Policy that will give priority to younger, healthier people over older, sicker patients for the best kidneys.

The National Organ Transplant Act (NOTA) of 1984 called for an Organ Procurement and Transplantation Network (OPTN) to be created and run by a private, non-profit organization under federal contract. UNOS was first awarded the national OPTN contract in 1986 by the U.S. Department of Health and Human Services. UNOS continues as the only organization ever to operate the OPTN.

Did you know that the length of time donated organs and tissues can be kept outside the body vary? Here are the facts by organ: In response to the shortage of organs for transplantation, relatives, loved ones, friends and even individuals with no prior relationship are serving as living donors for the growing number of people on the national organ transplant waiting list.

A living donor can save and/or greatly improve the quality of life of a transplant candidate. However, one should only make a decision about donating an organ after being fully informed of the possible risks and benefits.

Source: The United Network for Organ Sharing

Written by Sy Kraft, B.A.
Copyright: Medical News Today
Not to be reproduced without permission of Medical News Today

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Sy Kraft, B.A.. "Under New Law, Kidney Transplant Priorities Will Shift." Medical News Today. MediLexicon, Intl., 25 Feb. 2011. Web.
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Visitor Opinions (latest shown first)

Total 23 opinions, latest 20 shown. For all opinions, click through to the full thread.

where's the guarantee? Kidney transplant

posted by Suzanne on 17 May 2011 at 2:40 pm

If a younger recipient gets the kidney but is non-compliant won't that kidney fail irrespective of age?

If a younger recipient gets the kidney but has diabetes won't that new kidney eventually fail?

What about all the first class nephrologists who have been careing for kidney patients? If they are over 50 will they become second class recipients?

What about those with polycystic kidney disease whose kidneys usually fail at mid life? Will they be peanilized because their native kidneys have lasted just a little too long?

Do we know the average life span of a transplanted kidney by the age of the donor?

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Obamacare

posted by Catherine on 27 Mar 2011 at 7:13 am

Uh-oh--looks like Big Brother is invading our very lives with "guidelines." Where are our rights to life,(liberty and the pursuit of happiness?)Answer: we have no rights under "enlightened" Obamacare.

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Not fair

posted by Deanna on 10 Mar 2011 at 1:19 pm

I know life is not fair, but leaving the best for the youngest? Come on now, if this thing goes through, the patient will have false hope when the physician says that they can get a kidney transplant to elongate their lives. For example, physicians tell patients they can live for years on dialysis, when I've seen people die within a few months from the dialysis not working right. Then again, you also have the risks with a kidney transplant also, your body may be reluctant to accept the new kidney. But I disagree with this.

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should age matter

posted by Larry Bush on 2 Mar 2011 at 9:05 am

It seems to me that a kidney recipient's past contributions to society and lifestyle together with life expectancy should be factors entered into the transplant decision equation. The kidneys from our cadaver donor were shared between myself and a 77 year old retired Army Colonel Engineer. The Colonel was actively engaged in several engineering projects in which he has continued heavy involvement subsequently, thereby benefiting society. So, age matters but it should not be the sole determining factor.

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Kidney Transplant Priorities Will Shift.

posted by Robert Hickey, Ph.D. on 1 Mar 2011 at 9:48 pm

I have attended many of the UNOS meetings regarding this new proposal to give preference to those patients needing kidney transplants 49 Years old and younger. As Dr. John Fung, Transplant Surgeon at Cleveland Clinic and former UNOS board member stated before a congressional field hearing, "UNOS' stock in trade are lies and misinformation!"

First, UNOS has tried to spend this issue as being for the benefit of children. Nonsense! Children already have priority on the national transplant waiting list.

I spent 5+ years on the waiting list for a kidney. No Luck! I began to advocate for myself and found an altrusitic, non-related, living donor on a website. UNOS attempted to stop my life saving kidney transplant on 10/18/04. Only because I had the financial ability to threaten legal action against the transplant center, St. Luke's Presbyterian Hospital in Denver and UNOS did I get my kidney transplant on 10/20/04.

This proposed change in kidney allocation policy on the part of UNOS/OPTN is totally criminal! UNOS is the private government contractor holding the monopoly on cadaver organ transplants in this country. UNOS is supposed to be a non-profit entity by law. (National Organ Transplant Act [NOTA]. The UNOS CEO, has become a millionaire. No one gets an organ donated to them in a time of need. The average 'organ procurement fee' paid to UNOS and the OPO for each kidney transplant is $45,000.00. The largest OPO in the country made more than $130 million in 2009.

This proposed change is all about money and selling Expanded Criteria Donor organs to unsuspecting people 50 years old and older. Many of these ECD organs are contaminated and until now would have been discarded as unsuitable for transplantation. In fact, there are numerous law suits across the country by families whose loved ones have died after having these organs transplanted into them.

The CEO of UNOS, makes more than $1 million annually. He wants to increase his income through sale of these ECD organs to older people who under these proposed new kidney allocation rules will have no other choice.
The transplant system in the US is broken, corrupt, and unethical! Beware UNOS and the OPTN!!!

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Is HItler back?

posted by Nadia on 1 Mar 2011 at 2:21 pm

This is deciding who is going to live and who is going to die. I understand that this country is religious. I am not. I even don't believe in God. But I firmly believe that we cannot decide about someone else's life or death!!! Try to explain these new guidelines to the patient and his/her family. Where is our society going?

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Reward for good behavior?

posted by CoachRichie on 1 Mar 2011 at 2:08 pm

What about a second transplant?

If an individual has been living with a transplant for many years, and is now older, is this individual punished for living longer???

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I'm looking for the truth about changes to transplant criteria

posted by Dana on 1 Mar 2011 at 5:40 am

So far, I have seen a 2:45 minute story on ABC News and an unsigned opinion in the NY Times about this so-called "proposal." I've written to both of them to use UNOS as a source for their information. ABC News admitted to not having gone to UNOS. So far the writer of this article, Sy Kraft, is the ONLY reporter to cite UNOS as a source and to demonstrate knowledge of the workings of the OPTN system.

However, he states "The nation's organ transplant network is proposing that patients and transplant kidneys be graded and separated into groups." Note please: KIDNEYS. I'm on the LIVER transplant list, age 63, and there are different rules for different organs. I do thank you for including "kidney" in the headline and continuing that reference throughout the article. I do believe, though, that there should be a reference in at least passing about the different criteria for different organs. Thank you, Medical News Today and Sy Kraft. So far, so good.

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Who is worth saving?

posted by Colin B., MBA, PhD. on 28 Feb 2011 at 10:11 am

This is a clear case of age discrimination and therefore illegal. To determine who is going to live longest you have to dig into lifestyle habits and genetics (children of long-lived parents tend to live longer). Then there's the question of what sort of return you get by making an investment of an organ in a younger person instead of an older person, for example a thirty-year old with no skills to offer versus a fifty-year old highly qualified cancer-research scientist. I intend to live forever, so therefore I should have the highest priority.

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Think again

posted by Diane on 25 Feb 2011 at 7:14 pm

With no way of knowing the actual reasons behind this proposal, or whether or not the proposed new rules are politically motivated, we still see a blatent unfairness to them. If this proposal becomes reality, anyone over 50 or 60, who has waited a long time and is finally getting close to the top of the list, will be devastated by the news. For such a person, or for anyone over that certain age, this will be a death sentence. My message to UNOS: Think again. If you can't come up with another allocation method fairer to ALL than the current "first come, first served" method, perhaps you should use the old adage, "if it's not broke, don't 'fix' it." Age should not determine whether a person lives or dies. This proposal will alienate a lot of people over (or close to) age 50. Thank you for allowing my comments.

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Compliance Issues

posted by Mario on 25 Feb 2011 at 3:20 pm

I do understand the basis behind this idea, however, you have to look at patient's overal compliance to determine who is best to receive a transplant. For instance, you may have a 20 year old kidney patient who does show up for dialysis or most importantly, does not take his meds and on the other hand, you may have a 45 yr ols person who is very responsible and does everything correctly. Who out of these two individuals is best equiped to take care of their kidney once transplanted??

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Obama Lies Again

posted by Charlie on 25 Feb 2011 at 2:27 pm

If Obama could just have black and hispanics only get organs, he would do that. Today kidneys, tomorrow, livers, hearts, etc. And they said they weren't killing off old people. More Obama lies!

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This IS the Death Panels.

posted by thnkfstpal on 25 Feb 2011 at 2:13 pm

Read it and weep. Wake up America!! It's not left or right it's right and wrong.

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it makes sense

posted by ahmad on 25 Feb 2011 at 2:05 pm

im sure no one knows how it feels to have to choose who dies and lives everyday and we shouldnt cuz none of us are god, but when it comes down to logic why be wasteful, everyone has to go sometime, but let sum atleast experience life when some already have

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alcoholics

posted by kevin on 25 Feb 2011 at 1:47 pm

I agree with allocating organs to those who have the POTENTIAL to live longer... but what of alcoholics who have a greater life expectancy than one who isn't? Is it fair to give an indivudal in their 30's a new liver with the potential to live 30-40 years who had a perfectly good liver and destroyed it versus an elderly patient who has no history of alcoholism and is expected to live 10 years due to other concurrent medical conditions?

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becaue you are old, let them die

posted by eugene on 25 Feb 2011 at 1:46 pm

Now it is a choice who will live longer and not who needs it most. Old people are being destined for the pasture.

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hmm

posted by john on 25 Feb 2011 at 1:43 pm

previous commenters were right we need more dead bodies.

My proposal:
Free guns for inner city gangs. this will provide fresh, healthy corpses. Was pondering free crack outlets, but that might result in unusable drug addled bodies.

Maybe the guns could have wireless transmitters to alert organ harvesters after each discharge.

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Lifeboat? Anyone?

posted by David on 25 Feb 2011 at 1:39 pm

So now who deserves to live and who deserves to die will be determined by criteria set forth under these standards. Has anybody considered that a high percentage of those needing transplants are 50+ and a high percentage of donors are accident victims under 30? Guess those leftover kidneys can just be ground up for dog food- no use in giving them to a living, breathing human. Geez our society has no hope.

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Priority to donors

posted by Glenn on 25 Feb 2011 at 1:33 pm

Why dont we give priority to people who have been signed up as donors? That can be done at 17 with your driver's license . Then give organs to people at 40/50/60 who have been signed up the longest. Maybe that would increase the supply of vital organs?

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Death Panels

posted by David on 25 Feb 2011 at 1:21 pm

Looks like the ObamaCare Death Panels have become a reality. Big hit for anyone over 50!

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