"The Gross Inequality Of Organ Transplants In America" - Jordan Michael Smith

Lisa Waters was 25 years old when, one day in 1995, she couldn’t raise her right arm without pain in her shoulder. Blood tests revealed she had a rare autoimmune liver disease, primary biliary cirrhosis that can cause liver failure but can be delayed or even forestalled with medication. For the next two decades, Lisa took a drug, Urso, thrice daily and remained in good health. All was well until two years ago, when one day she began vomiting blood for no apparent reason. Doctors at The Mount Sinai Hospital told Lisa that her PBC had progressed and she might need a liver transplant soon – if she could get one in time. There’s a nationwide organ shortage. More than 115,000 Americans are on waiting lists for organs – mostly kidneys and livers – but because of how transplants are regulated; the severity of the shortage varies by geography. The United Network for Organ Sharing (UNOS), the government-sanctioned organization responsible for allocating organs, divides the country into eleven regions; for the most part, organs must be transplanted within the same region in which they’re donated. But not all regions are equally in need. Since UNOS can’t restrict transplant candidates like it does organs, Lisa’s doctor suggested she get listed in a region with a higher organ supply, to increase her odds of survival. For two decades, transplant surgeons in these regions have pushed UNOS to reduce these geographic and economic disparities. “It’s supposed to be about fairness—equal need should have equal opportunity—but it is often about money and transplant centers protecting their self-interests,” said Sander Florman, MD, director of the Recanti/Miller Transplantation Institute and professor of surgery at the Icahn School of Medicine at Mount Sinai. “It’s disgraceful.”

- Sander Florman, MD, Director, Recanti/Miller Transplantation Institute, Professor, Surgery, Icahn School of Medicine at Mount Sinai

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