A national organ-sharing network is threatening sanctions that could severely curb the state's ability to obtain kidneys for local transplants -- a move that could have life-or-death consequences for scores of patients in Maryland.
Two of Maryland's most prominent hospitals -- Johns Hopkins School of Medicine and the University of Maryland Medical Center -- have been so successful in their transplant programs that they have inadvertently helped give the state the largest kidney "debt" in the nation.
Maryland's debt yesterday stood at 64, according to the Transplant Resource Center of Maryland. It was calculated as the surplus of kidneys brought here for transplants over those shipped to patients out of state.
United Network for Organ Sharing (UNOS), the nonprofit group that holds a federal contract to enforce transplant policy nationwide, has notified local medical officials that the imbalance must be cut by 50 percent by November. The next step would be to require the state to ship nearly all kidneys it obtains to other states. Kidneys collected from living donors would not be affected.
"This could severely increase the waiting times for people on the kidney waiting list, which is already pretty high, by saying that every kidney donated here will go out of your territory until you pay us back," said Joseph O'Donnell of the Transplant Resource Center of Maryland.
Dr. Andrew Klein, director of the comprehensive transplant center at Hopkins, said he would be very concerned if Maryland were singled out for sanctions.
"The guiding principal in allocating kidneys should be the best medical practice," he said. "Because these centers are successful and more patients want to be cared for here, that somehow is negatively calculated. It is not ethically justifiable."
Lengthy waits
The 1,500 patients on Maryland's list awaiting kidneys face extensive waits. On average, Caucasians wait 790 days for a kidney transplant in Maryland, compared with the national average of 553 days. African-Americans here wait 1,452 days compared with the national average of 1,082, according to the most recent figures.
After a meeting in June, UNOS notified transplant officials across the country that those with a debt higher than 10 kidneys must reduce their numbers by 50 percent by November or face sanctions.
