In 2009, the late Apple founder Steve Jobs, who lived in Northern California, famously underwent a liver transplant in Memphis, Tenn. There, he had put himself on one of the shortest waiting lists in the country. In Tennessee in 2006, it took 48 days to receive a liver transplant, compared with 306 days nationally. Jobs was able to do this because he had the financial resources to immediately fly to Tennessee when the liver became available. His situation brought national attention to the large geographic disparities in liver transplantation.
Segev, a transplant surgeon, says that if a patient from San Francisco or New York City needed a liver transplant, it would be difficult to recommend one of the great transplant centers in those cities because the wait is so long.
In developing their new allocation model, the Johns Hopkins researchers essentially redistricted the regions by analyzing supply, demand and access factors for 6,700 deceased donors, 28,063 liver transplant candidates and 242,727 changes in 2010 to what is known as MELD (Model for End-Stage Liver Disease), a score that categorizes the sickest patients on the list at any given time.
The optimal regional sharing map they created would reduce geographic disparity by half, while significantly reducing waitlist deaths.
Segev, the director of clinical research for transplant surgery at Johns Hopkins, says that the geographic disparity in the current allocation system violates government rules that say geography shouldn't affect organ supply.
He says he hopes the United Network for Organ Sharing, the private, nonprofit organization that manages the nation's organ transplant system under contract with the federal government, will act on this new model.
|Contact: Stephanie Desmon|
Johns Hopkins Medicine