Judge rules in favor of Vanderbilt in lawsuit against new organ sharing policy

Posted at 11:16 AM, May 16, 2019
and last updated 2019-05-17 16:42:49-04

NASHVILLE, Tenn. (WTVF) — A federal judge in Atlanta issued an order Wednesday temporarily halting a new policy for distributing livers for transplant.

According to Vanderbilt University Medical Center, it would have had a negative effect on patients on the wait list in Tennessee and Kentucky, which is why they asked for a reversal.

"It would move a tremendous amount of organs from the South to New York," said Dr. Seth Karp, director of Vanderbilt's Transplant Center.

In April, VUMC and 13 other liver transplant centers filed a lawsuit against the Acuity Circles Policy. The policy would allow sick people up to 575 miles away from a donor hospital to receive the liver transplant, replacing someone who is closer to the hospital.

"People in rural states, especially in the South or people that live far from a transplant center, which is the population we serve, those patients die more often than you would expect based on their [MELD] score," Dr. Karp said.

A MELD score helps doctors determine how quickly a patient needs a liver transplant. It measures someone's risk of dying in next three months.

Dr. Karp said Tennesseans who live in rural areas have limited access to healthcare. It's a stark comparison to the access in some of the wealthier and urban areas where livers would be sent to with the new policy in place.

"Their donation was terrible and they had a decision to make," Dr. Karp said about the states with low donation rates. "The decision was to make their donation better or to try, quite frankly, to get organs from other parts of the country."

The original policy for sharing livers limits how far the organ can travel to just one or two states away. For example, a liver donated in Tennessee can only go to Kentucky, Virginia, North and South Carolina.

For roughly 48 hours earlier this week, the United Network for Organ Sharing (UNOS), the nonprofit organization that runs the transplant system, adopted the policy that would expand organ sharing.

"This was a mistake," Dr. Karp said.

Kelsey Yates is 23-years-old and received a new liver at Vanderbilt on May 1. She was scared the policy would prevent her from getting that liver in time.

"People aren't going to make it and it's not fair," Yates said. "You kind of deal with survivor's guilt because you're like I made it, and you think about the people who haven't made it and won't make it because of a simple law change."

UNOS is standing by the new organ allocation policy. It maintains that the policy would reduce pre-transplant deaths, increase rates for pediatric recipients and make geographic location of patients less important than how sick they are.

UNOS responded with the following statement:

"There have been many legal developments over the last week regarding the liver allocation policy and we appreciate the much-needed clarity provided by the court on May 17, 2019. Per this direction from the court, UNOS is in the process of reverting back to the map-based, donor service area (DSA) liver allocation system. Reprogramming this complex and important system is not a simple process and will take time to execute. However, it is underway now and UNOS will have a greater sense of when the work will be completed next week.

While patients may be hearing conflicting information, it is important that they know that donated livers will continue to be allocated to patients on the waiting list, as always. The computer network used by UNOS for organ matching and distribution, UNet, is fully operational and matches are being made using the acuity circle policy that was implemented on May 14, 2019.

Last year, 1,155 patients died while waiting for a liver transplant. UNOS and its expansive network of experts and professionals remain committed to successful organ transplantation and seeking ways to reduce the number of patients who die each year while waiting."

Despite the judge's ruling on Wednesday, the legal fight will continue.