A national organ-sharing network withdrew sanctions yesterday that would have forced Maryland's primary transplant center to severely curb the use of kidneys for transplants in the state.
The move was a pardon of sorts for the Maryland Transplant Resource Center and dozens of local patients awaiting kidney transplants who would have dropped to the bottom of a national waiting list for organs.
The United Network for Organ Sharing, a nonprofit group that holds a federal contract to enforce transplant policy nationwide, threatened in June to restrict Maryland's access to organs to reconcile the state's 67-kidney "debt." That debt, by far the largest in the nation, is the surplus of kidneys brought here for transplants over those shipped out of state.
In exchange for the network's action yesterday, the transplant -- center agreed to a plan it expects will increase local kidney donations and the number of organs available to send to other states.
"It's a definite reprieve for our patients," said Marion Borowicki, executive director of the transplant resource center. But Borowicki said there is no guarantee the plan will permit Maryland to continue conducting transplants at its current pace.
"It's the lesser of two evils," he said. "We're hoping this will have little impact on our patients and not significantly extend their already long waiting times."
Kidneys collected from living donors are not affected by the plan.
UNOS board members, in Baltimore for a meeting yesterday, promised to review their formula for calculating the debt after it was criticized as unfair.
The formula works against Maryland in some respects because the state is home to two of the nation's most prominent transplant programs, the Johns Hopkins School of Medicine and University of Maryland Medical Center, several board members said. More than one-third of the people on Maryland's waiting list for kidneys do not live here, Borowicki said.
In addition, the two programs frequently succeed with kidneys that have been rejected by transplant programs in other states. More than half of the kidneys Maryland offered nationally this year were not accepted. Of those, 75 percent were transplanted successfully here and figured into Maryland's debt.
"These people have played entirely within the rules," board member Thomas Gonwa said yesterday. "Now we're telling them they've done too good a job, and they're going to be penalized. Who's going to explain that to the patients?"
Through increased staffing to bolster programs and a new state law encouraging donations, the Maryland transplant center expects a 15 percent increase in donors next year. The same programs helped increase kidney recoveries by 20 percent over the past year.
The 1,500 patients on Maryland's waiting list have longer-than-average waits. On average, Caucasians in Maryland wait 790 days for a kidney transplant, compared with the national average of 553 days. African-Americans wait an average of 1,452 days, compared with 1,082 nationally. It is difficult to find kidneys biologically compatible with patients.