Transplant Proposal Could Cut Off Region Local Patients May Have To Wait 100 Days Longer For Transplant

People waiting for an organ transplant in the Inland Northwest would wait even longer under a plan proposed by the federal government, area transplant doctors say.

The plan announced Thursday by the Department of Health and Human Services would eliminate the current organ-allocation system. That system divides the nation into regions and gives potential recipients priority for receiving organs donated in the same region.

The federal plan would make organs available to the sickest patients, no matter where they live.

The initial plan targets liver transplants, which are not performed in Spokane. But the federal government also plans to eliminate regions for other organ transplants, which are performed at Sacred Heart Medical Center.

Doctors in Washington say the plan would hurt smaller transplant centers, such as those in Seattle and Spokane, and snarl the waiting list for transplants for local people.

“This is bad on a whole variety of fronts,” said Dr. Timothy Icenogle, director of the Inland Northwest Thoracic Organ Transplant Program. “There’s so many bad things about this, it’s hard to know where to start with the badness.”

Inland Northwest residents may have to wait longer for organs, especially those people who aren’t considered to be the sickest people on the waiting list. The sickest people often need more than one transplant, using up valuable organs, doctors say.

Area doctors also worried that the plan would discourage people from donating their organs because they no longer would benefit local people.

The doctors stressed that the one solution to the organ shortage is more organ donors.

In announcing the plan, the Clinton administration tackled a controversy that’s bubbled for years among organ transplant surgeons and essentially ordered the private network that distributes organs to change its practice.

The president of the United Network for Organ Sharing said the proposed regulations mean that fewer people would get liver transplants and fewer lives would be saved.

Right now, organ transplants in the Pacific Northwest are coordinated by LifeCenter Northwest, an organ procurement agency designated by the federal government. LifeCenter handles one of the largest geographic areas in the country - Alaska, Washington, North Idaho and Montana.

Organs are matched with patients based on factors such as how long the patient has waited, medical compatibility and urgency.

LifeCenter officials don’t have a position on the federal plan. “Our mission is to provide organs for transplant so lives can be saved,” said Jill Steinhaus, spokeswoman for the agency. “It doesn’t matter if those lives are in Washington or in Cleveland, Ohio.”

The current system works on the premise of local organs for local patients.

For instance, if Spokane organs cannot be matched with local patients, the search broadens to the Northwest region, and finally to the nation, where 58,033 people were on the waiting list for organs of all types Friday. A new name is added to that list every 18 minutes, and nearly 11 people die every day waiting for a transplant.

Patients in Spokane now wait about a year for a liver transplant, 1-1/2 years for a kidney and from six to 12 months for a heart, said Spokane Dr. Robert Golden, the regional representative for UNOS.

Transplants of kidneys, hearts and lungs are performed at Sacred Heart. Liver transplants are performed in Seattle and Portland.

“It’s true that the secretary’s requirement would advantage the acute liver patients throughout the whole country,” Golden said. “The disadvantage is other patients would have to wait longer and have a greater chance of dying.”

Under the plan, people in the Pacific Northwest would wait on average 100 days longer for a liver transplant, said Dr. James Perkins, director of transplantation for the University of Washington Medical Center and Children’s Hospital and Medical Center.

If the proposal is extended to kidneys, people in the region would wait two to three years longer.

“This policy would benefit the large-population areas,” Perkins said.

Area doctors also said they were concerned that livers from Spokane could be sent to larger centers such as San Francisco and Pittsburgh. This could hurt the liver program at the University of Washington.

Some transplant patients can’t afford to go to larger centers for transplants, doctors said.

, DataTimes MEMO: This sidebar appeared with the story: ON THE WEB The new organ transplant plan is available on the Internet at http://www.hrsa.dhhs.gov/osp/dot.main.htm. There is a 60-day comment period.