金沙开户注册官网:Who needs a new liver?
By Kurt Kleiner Washington DC LIVER transplants in the US are to be regulated by the government. Self-regulation by doctors has led to complaints that sick patients are dying while others who are not particularly ill are having transplants. About 7300 people in America are waiting for liver transplants, but only 4000 livers become available every year. In 1984, Congress handed over the regulation of transplants to the United Network for Organ Sharing (UNOS), based in Richmond, Virginia. Most of its members are transplant surgeons. The UNOS divides the US into regions. Livers are offered first to the sickest patients in the region where they are donated, then to the less sick. They are only offered to patients elsewhere if no match is found. The rationale is that organs need to be transplanted fairly soon after donation. But livers can last up to 24 hours. Critics say the system is a device to keep smaller transplant centres in business. The US has 118 transplant centres. But about half the transplants are performed in the 10 largest ones. Charles Fiske, head of the National Transplant Action Committee, a pressure group, says if livers went to the sickest patients, most of the transplants would be carried out in the large centres. Many smaller centres would go out of business, which is why they want to keep the regional system, he claims. In November, the UNOS voted to make it easier for livers to be used in different regions. But at the same time, it ruled that people with chronic diseases such as hepatitis and cirrhosis would no longer have top priority. The decision puts patients who may have only days to live in the same category as those who might survive months or years. Fiske claims that the reason for this decision is to reduce the competition faced by smaller centres for organs donated in their regions. James Burdick, president of the UNOS board of directors and a surgeon at Johns Hopkins Medical Center in Baltimore, rejects this accusation,