Critics Of HHS Organ Policy Focus on Supply

July 7, 2008 - 8:02 PM

( - Opponents of proposed changes to the nation's organ transplant regulations are charging the Department of Health and Human Services (HHS) of being "more concerned with a bureaucratic power grab than with increasing the supply of viable organs," according to one transplant surgeon.

"They should be coming up with ways to increase the supply, not tinkering with the rules about who gets organs," said John Starsel, a transplant surgeon in Charlottesville, Va. "Doctors and medical professionals ought to make decisions about organ allocation, not bureaucrats."

The comments to came one day after the state of Wisconsin filed suit to bar the federal government from instituting new rules that would change the present regional allocation of organ to a national system.

Wisconsin is contesting a plan from HHS Secretary Donna Shalala that would create a national database of transplantable organs, scrapping the present system where regional organizations - working with local doctors - distribute organs within a specific area.

"These (proposed) rules benefit states that have poor organ procurement programs," said Wisconsin Gov. Tommy Thompson in a statement. "Instead of taking organs from Wisconsin and other successful states, the federal government should work with struggling states to improve their programs."

Wisconsin's organ donation rate is 80 percent higher than the national average of 20 organs per million people nationwide.

Nationwide, there are more than 500,000 people waiting for major organs such as a heart, lung, kidney or pancreas each year.

A spokesperson for the Cleveland, Ohio, affiliate of LifeBanc, a private organ allocation organization, echoed Starsel's comments.

"The government should be expanding programs to convince people to donate, rather than changing the allocation rules," said the spokesperson. "It's more effective to work on the supply, not manage the demand."

Critics of the plan, such as University of Wisconsin transplant specialist Anthony D'Alessandro, claim that transportation problems make the HHS plan unworkable.

"There are constraints on organ viability," D'Alessandro told wire reporters. "In our experience, the shorter the preservation time, the better the function, the better the outcome and the more likely that the transplant will be successful."

Shalala, in a statement about the proposed rules, said that organ transplant allocation "must take place over broad enough areas to ensure that organs can reach the patients who need them most, and for whom transplantation is most medically appropriate."

Shalala stresses that the new rules are derived from an independent Institutes of Medicine study that recommended a nationwide system.

The Secretary added that even under the new rules, doctors would maintain control of the decision-making process on who receives organ transplants.