Transplant patients are ill-served by organ rule changesI...


July 30, 1999

Transplant patients are ill-served by organ rule changes

I appreciate The Sun's editorial support of Maryland patients on the kidney transplant waiting list ("Playing politics with life-saving transplants," July 25).

The rule changes that the United Network for Organ Sharing (UNOS) instituted June 24 demote Maryland patients waiting for perfectly matched kidneys and send a message to future patients to choose a state other than Maryland.

We think that's unfair. It's bad medicine, and it violates patients' rights.

The organ transplantation network was set up to bring equity to organ sharing and give patients equal access based on medical need, not geography.

At the Transplant Resource Center of Maryland, we have been working with the transplant programs at the Johns Hopkins Hospital and the University of Maryland Medical Center for many months to reason with the United Network for Organ Sharing (UNOS).

We thought we had settled this controversy last November, when UNOS agreed to lift sanctions and we agreed to reduce Maryland's organ debt. But UNOS has bowed to pressure from its members and modified its rules to punish Marylanders.

UNOS continues to ignore our arguments that our patients already wait longer for kidneys than patients almost anywhere else, that the success of our hospitals attracts patients from outside our area, that we are trying to pay organs back, that we've broken no rules and that the payback system is flawed.

We will continue to support our patients, try to reason with UNOS and, if necessary, follow The Sun's recommendations to engage our political leaders and court system in this dispute.

But, no matter how we allocate organs, we don't have enough to go around. So we encourage everyone to become an organ and tissue donor.

Marion Borowiecki, Baltimore

The writer is chief executive officer of the Transplant Resource Center of Maryland.

State should establish clear `transplant leaders'

As The Sun's editorial "Playing politics with life-saving transplants" (July 25) noted, many issues regarding organ transplants need the attention of "state transplant leaders."

The problem is that the state has no such entity. The 1998 Maryland General Assembly fell well short of addressing this need. It created an advisory council, but limited its scope to recommending how to promote organ and tissue donation.

The system leaves important public policy issues to private organizations with inherent conflicts of interest.

Maryland's legislature should revisit the transplant question, at least long enough to establish a body of "state transplant leaders."

Howard I. Golden, Baltimore

Drug price-control bill could hurt cancer patients

Legislation sponsored by Rep. Elijah E. Cummings that would bring more than 40 percent of the pharmaceutical market under price controls should carry a warning label: This bill could be hazardous to people suffering from such uncured diseases as kidney cancer.

Some 30,400 Americans have kidney cancer and 600 cases were diagnosed in Maryland last year. This legislation would hurt those patients, by hurting research for a cure.

Price controls and innovation don't mix. Price controls will discourage private-sector pharmaceutical research and deprive thousands of kidney cancer patients of hope for a cure.

We can help needy seniors without hurting incentives for research.

Let's modernize the Medicare program so that seniors who lack prescription drug coverage have it. But let's do it in a way that doesn't cripple medical research.

Carl Dixon, Evanston, Ill.

The writer is executive director of the National Kidney Association.

Legionnaires' outbreaks need more careful attention

As a physician who consults at Harford Memorial Hospital, where we recently had an outbreak of Legionnaires' disease that killed three patients, I want to bring it to public attention that such outbreaks are not uncommon in hospitals and nursing homes ("State task force considers new anti-infection rules," July 23).

Leading experts in Legionnaires' disease believe these outbreaks occur regularly in the country's pre-eminent hospitals but are often swept under the rug.

Unfortunately, outbreaks of this disease don't have to be reported to the federal Centers for Disease Control and Prevention (CDC).

However, the CDC, working with state health agencies, needs to set to set national guidelines for prevention of Legionnaires' disease. Infighting among the factions involved seems to be preventing such an enlightened approach.

In the meantime, hospitals are terrified of the bad publicity and lawsuits Legionnaires' disease outbreaks can bring and use damage control and stopgap measures to deal with this deadly bacteria.

Dr. Usha Nellore, Bel Air

Can't city officials read a weather forecast?

I was amazed by Baltimore City Health Commissioner Dr. Peter L. Beilenson's statement that had he known earlier about heat-related fatalities, he would have issued "a full-scale alert" ("10 Md. deaths blamed on heat," July 24).

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