Md. transplant centers sanctioned for `kidney debt' to organ network

Move will increase wait for patients at UM, Hopkins hospitals

July 16, 1999|By Rafael Alvarez | Rafael Alvarez,SUN STAFF

If you are a Marylander in need of a kidney, your long wait might have become longer.

The United Network for Organ Sharing (UNOS), a national group that directs organs to hospitals around the country, has imposed sanctions on Maryland transplant centers because of a large "kidney debt" incurred in the state.

The average state owes UNOS less than a half-dozen kidneys in return for organs received. Maryland -- home to two of the most successful kidney transplant centers in the nation, University of Maryland Medical Center and Johns Hopkins Hospital -- has a debt of 57 kidneys.

In November, the number of kidneys owed to UNOS by the Baltimore-based Transplant Resource Center of Maryland stood at 68. After much wrangling, TRC, which coordinates local organ donations, agreed to cut its debt in half within a year.

Though the local center said yesterday that it has been making steady progress to reduce the debt, UNOS is unhappy with the pace and decided at a June 24 board meeting in Atlanta to deny out-of-state kidneys to patients waiting for them at Maryland transplant centers.

"It's not for every kidney that comes up, just when there's a near-perfect match," said Robert A. Spieldenner, a spokesman for UNOS, based in Richmond, Va.

"In the past, a near-perfect match would go to anyone in the country who matches. If there are two or more, the person waiting the longest would get it. Now, if it's between a Marylander and someone in another part of the country, it would go to the other patient, even if the Marylander has been waiting longer."

The rule will not take effect for several months while UNOS reprograms computer software that helps direct the distribution of organs. In that time, the Maryland medical community hopes to reverse the decision by lobbying, enlisting the help of lawmakers on Capitol Hill and, if necessary, filing a federal lawsuit.

On Wednesday night, the board of the Transplant Resource Center met in Baltimore and voted to "continue to try and negotiate a more common-sense resolution of our debt problem," according to Marion Borowiecki, chief executive officer of TRC.

"We're investigating taking federal court action as a last resort if we're unsuccessful at reaching a compromise," Borowiecki said. "Our patients are being singled out unfairly."

Local transplant surgeons say the sanctions are an example of good hospitals being penalized for their success.

As of May, 1,619 people were waiting for kidneys in transplant programs at University of Maryland and Johns Hopkins hospitals.

"This whole thing boils down to the fact that UNOS is not anxious to re-examine the rules for organ allocation," said Dr. Stephen T. Bartlett, head of the University of Maryland Medical Center's division of transplantation.

"Because the state of Maryland has two very successful kidney transplant programs, patients are coming from many states. UNOS is telling us to only transplant as many kidneys as we produce. They have to deal with the fact that transplant programs have become regional. All we're asking is for regional allocation policies."

While the medical community argued over the equity of organ allocation, 14-year-old Ryan Tripp of Utah hopped on a big red riding mower adorned with a Maryland flag yesterday and cut a few wide swaths across the State House lawn in Annapolis.

It was lawn No. 35 in his summerlong quest to cut the grass at all 50 state capitals to raise awareness about the need for organ donors.

The Associated Press contributed to this article.

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