WASHINGTON -- Where you live can affect your chances of getting a liver transplant, and your risk of dying while waiting. The nation's transplant network says it's time to make the system fairer -- and it may take a cue from how politicians redraw voting maps.
"Gerrymandering for the public good" is how Johns Hopkins University transplant surgeon Dorry Segev describes a proposal to change the map that governs how donated livers are distributed around the nation.
The problem: Some areas have fewer donated organs, and higher demand, than others. The sickest patients go atop the waiting list. But geographic variation means someone in California, among the toughest places to get a new liver, waits longer and is a lot sicker before getting transplanted than someone in Ohio or Florida -- if they survive. "This should not be happening," Dr. Segev said.
Dr. Segev is advising the United Network for Organ Sharing, which runs the transplant network, as its liver specialists consider the idea of "redistricting" how livers are allocated -- redrawing the 11 U.S. transplant regions based on the distribution and demand for donated organs, much like lawmakers set political districts based on the party voting histories of different areas.
Just 6,256 patients received a liver transplant last year, all but a few hundred from deceased donors. Nearly 16,000 people are awaiting a liver. About 1,500 people die waiting every year. Desperate patients sometimes travel across the nation to get on a shorter waiting list, if they can afford it or know it's possible.
The transplant network liver panel is mulling various map options as it debates how to improve fairness without having to fly organs too far across the nation.