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MyHealthNewsDaily
The way that donated kidneys are allocated to patients needing transplants might be changed next year, so that the fittest organs would be given to those likely to live the longest with the donated organ.
That was the announcement today from the United Network for Organ Sharing (UNOS), the nonprofit organization that manages organ donations in the U.S.
More than 93,000 people in the United States are on the waiting list for a kidney transplant, and the demand far exceeds the supply.
Currently, when kidneys from deceased persons become available for donation, they are offered to transplanted patients based primarily on how long the patients have been waiting for an organ.
Best kidneys should go to the right recipients, bioethicist says
While this system can be thought of as fair, "it does not strive to minimize death on the waiting list, nor maximize survival following transplant," UNOS says. In some cases, patients that receive relatively poor kidneys are likely to live many years after their transplants, and later need a second or third transplant from the already limited pool of donated organs.
Under the proposed policy, kidneys would be given a score that reflects how long the organ is likely to keep working in its new owner. People needing transplants would also be given scores — based on their age, years on dialysis and other factors — that reflect how long they are likely to benefit from the transplant.
The top 20 percent of kidneys would be offered to the top 20 percent of patients based on this score, UNOS says. The remaining 80 percent of kidneys would be allocated in much the same way as before.
Children would be prioritized to receive high-quality kidneys — those in the top 35 percent. Patients with very sensitive immune systems, who are extremely limited in the type of organ they can receive, would also have priority over those with less-sensitive immune systems.
Organs with low scores would be offered to patients in a wider geographic area than under the current system, to increase the chances that they would be used rather than discarded.
The changes could result in more than 8,000 total extra years of life, among all patients receiving a kidney in a given year, UNOS says.
However, experts say the effects of the changes will be marginal, and do not change the reality that the demands for organs is still far greater than the supply.
"It's not a major change," because it only affects 20 percent of patients, said George Annas, chair of the Department of Health Law, Bioethics & Human Rights at Boston University School of Public Health. "Obviously, it's not going to solve the shortage of organs problem," Annas said.
To address this problem, doctors need to do more to prevent kidney disease in the first place, so fewer people need transplants, Annas said.
"You can't just look at a shortage problem from the supply side, you have to look at the demand side too," Annas said.
UNOS is seeking comments from the public on the proposed changes until December, and the organization will vote on the proposal as early as June next year.
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@!$%# me It's gonna suck to be an older person and need a kidney.
"Sorry you wont get the max life expectancy out of the organ so you get to die mother @!$%#er."
If God takes me I want to leave this malfunction planet
The organ shortage problem could be fixed very easily. Just pass legisation that only allows those who signed up to be an organ donor at least 5 years in advance of needing an organ would be allowed one.
Minors could only get an organ if one of their parents had signed them up to be an organ donor.
Johnny.. Sadly we have a limited number of organs. Say you have 1 organ and 3-5 people, how do you suggest the decision be made?
The top 20 percent of kidneys would be offered to the top 20 percent of patients based on this score, UNOS says. The remaining 80 percent of kidneys would be allocated in much the same way as before.
Johnny if you're so concerned, read properly first before making asinine statements.
I really hope it goes the way he suggests. Supposing I die young and my organs are impeccable, I'd want my organs in someone young to make sure they get a full crack at life rather than wasting my organs on some 80 year old. I'd hate to see them get wasted, ya know? I'd rather give 50+ years of life to someone instead of 5.
Hey annon I read that it doesn't change how I feel it still pushes people waiting longer further down the list possibly so asinine this mother@!$%#er.
Nolan,
Not everyone who gets pushed down the list is 80+ that's the far end of the spectrum. What about a parent who has lets say, 15 years less to get out of that organ than someone else?
Are we going to let children lose their parents just for the sake of efficiency?
Mike,
I would say the decision of first on the list and closest to dying first in line that's how.
Johnny.. So you'd choose the 70 yr old with chronic alcoholism who is still drinking just because he is closer to dying and higher on the list?
Mike you guys keep using that 70 80 year old analogy to what...show me the injustice of a 70 year old getting a kidney first?
So I guess the only kinds of people on the list are really old drunks and really young kids?
Using extreme examples as if they are the only scenario doesn't work on me.
Have a nice day
>Johnny.. These are actually pretty common and not extreme examples. Volunteer in a liver transplant program for a while and you'll see a long line of "former" drug addicts and alcoholics waiting to be evaluated for organs. Many are still using and lie to your face saying they haven't used in years when their toxicology screen comes up positive for a list of drugs & etoh. You'd also be surprised at how many people attempt suicide and survive but then want a transplant a month later because they destroyed their liver. When it comes to dying people line up pretty quickly.
Lets hear the details about how you would choose which of 5 people to get 1 organ? Giving them to the sickest first will run you out of organs fast and wouldn't save many lives.
Well.....it DEFINITELY beats our current system of giving all of the good kidneys to the most famous and wealthiest people on the list, but I do also see the downsides.
Just ensure that prisoners are never ahead of people who have not committed any crimes.
they will still be on the top of the list
I worked as a transplant coordinator and that statement is absolutely untrue. Making irresponsible statements like that only upset people that are on waiting lists. There are many more people than celebrities that go to China or the Phillipines and buy organs. I would be more concerned about that then movie stars getting kidneys. Their insurance here has to pay for the screw ups from overseas. Educate yourself so you don't show your stupidity.
Oh please how do you explain Dick Cheney's numerous surgeries while young children die? It may not be frequent but I find it impossible to believe that who you are doesn't matter AT ALL.
Ah! The phase-in of Obama's Death Panels begins..
Absolutely, another phase of Obamacare and the killing of those he thinks aren't worthy of his beneficense. VOTE VOTE VOTE in November before the one kicked off the list arbitrarily is you or yours. Repeal Obamacare before the death panels are in complete control of your very life.
you said it, this is only just begun. We need to gid rid of ACA.
This has nothing to do with Obama or the ACA. These proposals have been in the works for long before Obama was in office. Look up LYFT-> Life Years From Transplant. This was in an earlier version of reallocation based on similar principles while Bush was in office -> neither his idea or fault. The political landscape is toxic enough. Please refrain from spreading it to places it does not belong.
duplicate
And you'd better get in your criticism against our wonderful health (insurance) reform before that speech is labeled and deemed "hate" speech.
I think the naysayers who denied death panels (or a panel by any other name that deems you not as worthy of the health care you would have been entitled to receive prior to health (insurance) reform have been proven wrong once again.
Don't even bother writing an angry denial to this post...just remember this conversation in the next few years.
death panels.....lol
I'm on dialysis myself but I have yet to see any death panels.
Those people that turned this into a political circus should be ashamed.
I am (for you).
Did you know that the number of people needing kidneys is actually higher? That's because there are people who don't qualify for a kidney transplant based on the one simple fact that they tested positive for drug use.
I guess they want to kill off the drug users faster.
Why in the world would anyone in their right mind want to give a drug addict a kidney? Especially if they ruined the good ones they had by using drugs? WASTE!!
Dawn:
Did you ever stop to THINK not everyone who does drugs is a DRUG ADDICT? And did you ever stop to THINK that some drug users didn't lose their kidneys due to drugs? You assume a lot.
But, I can tell from your first statement you are for killing off drug users. But, you would be OK with giving a kidney to someone who drank alcohol, right?
@OneDirtyRat - I agree with you 100% about the political crowd and how they should be ashamed. This is not a political discussion. The UNOS is a 501c3 (Charity) which is controlled by a panel. It is not run by the government.
The "OMG ITS A DEATH PANEL!!!!" crowd are seriously a bunch of idiots need to get thrown in school. Anyone that pulls their organ donation for some political reason is an idiotic coward and should be ashamed.
It is very apparent that you have not read the entire 2,500+ page law. I have and the medical review panels are definitely defined. Yep, over 60 and you'll have to say goodbye.
Medical review panels are needed to see who gets a kidney first based on many criterion and would be necessary regardless of whatever insurance plan or Obama plan or right-wing medical plan or whatever. They are not a panel to determine who dies first. That is ridiculous. I thought that was left up to God?
A Death Panel (caps for emphasis) would be a panel, as it's named, who would determine who dies next as if people would be taken out back and shot execution style.
An exaggeration at best.
Yeah ... let's get rid of Obamacare and make sure these organs only go to those that can pay cash. Dick Cheney needs another heart; his last one died due to lack of use.
Those on the list the longest is not the only criteria, though it is the most fair way to allocate organs, if a person on the list deteriorates to the point of the new organ not being sure to aid then the person is taken off the list. NOW this decision is made by doctors, in the new OBAMA solient green world those decisions will be made arbitrarily by a panel of his cronies or obedient servants. VOTE and remember in November what is in store if you don't.
Exactly. Well Said.
Please---turn off Faux "news" and take a couple of deep breaths. Absolutely NOTHING in the Affordable Care Act is going to change the way organs are allocated, and nothing in the Affordable Care Act is going to take medical decisions away from doctors and give them to the President's "cronies." You people who get your "information" from right-wing media are so, so, sadly deluded. The ACA is far from perfect, but only because it allows the vultures in the for-profit health insurance to continue to lick at the bones of sick people. They should have simply done away with them altogether. They don't help sick people; they are in business to MAKE MONEY for themselves. Period. This nation that all of you fox-bots claim is so "exceptional" is the only developed country on earth that doesn't provide universal health care to ALL it's citizens. And for those of you who claim that the government just can't do anything right, they've been doing a perfectly fine job running Medicare, Medicaid, the Veteran's Administration, and the military's system of doctors and hospitals. How can it be possible that allowing vultures that provide no actual health care, only "administer" it, who make profits in the billions every year, somehow improves health care outcomes for people, even the lucky ones who are able to get insurance? Right now companies, including the one I work(ed) for, are laying off and firing everyone they possibly can over the age of 50 and/or has a chronic medical condition. And it isn't because of "Obamacare," it's because it's going to be more difficult for them to provide their own personal death panels. We've had death panels for decades in this country. The only difference is that they didn't work for the government, they work for the insurance companies. What do you think denying a person insurance because of a pre-existing condition is, other than an order of death for that person? No, the republicans and the faux-bots hate "Obamacare" not because it's going to devastate the country. They hate it because it finally forces the insurance companies to do their freaking jobs, which is pay for the medical care of sick people. For someone like me, that has a medical condition where I WILL die, within days or weeks, if I can't afford my life-saving medication, what do you think laying me off from my job and canceling my insurance is, other than a death panel? Fortunately the COBRA Act, which was made law over the screams of the insurance industry, forces the insurance company that wants to drop me to continue my coverage for another 18 months. But the loopholes, the hoops that I have to jump through, and the ways they can scam me out of my insurance now that I'm not protected by being a "covered employee" are literally mind-boggling. If I fail to cross one T or dot one I, I lose my coverage. If my check is received ONE DAY late, I lose my coverage. And if I lose my coverage, I WILL DIE. The Affordable Care Act will protect me, at least somewhat, from an insurance company that would rather see me dead than have to spend the money my medication costs. I so wish that you brainwashed right-wingers would at least bother to find out what is actually IN the ACA before you go spouting off about "soylent green" and "death panels." Now that more people are being protected from predatory insurance companies by the parts that have already gone into effect, and understand the protections that are going to phase in over the next two years, those of you who just repeat your faux lies and talking points sound, not only ignorant, but cruel, compassionless, and selfish.
Sadly the faux news people won't take the time to read what you have written let alone understand it. We are living in the Age of the Ostrich
Welcome to the Brave New World of Socialist Medicine and bureaucrat-run decision-making panels that will decide how and to whom healthcare will be given. Well, 47% of America, this is what you asked for, hope you enjoy it when it's your turn to sit on the waiting list.
Deafeat OBAMA in NOVEMBER!!!!
this is not an Obama based decision. And besides, didn't romney change his tune from 47% to 100%? Twisting in the wind my friend, twisting away.
This has nothing to do with what Romney said, so shut it. The 47% I'm referencing are those that voted for Obama last time. Since I'm working from a memory I wish to suppress, I might be off by a few percentage points. As far as an "Obama" based decision, this is definitely following the precedent set by the ACA. Google IPAB. You are the one that is twisting, words, ideas, morals, whatever, ...not me.
yeah right,you know that you were repeating Romney rhetoric otherwise you would have used proper numbers.
why not allocate arbitrarily based on religious affiliation? ;-9
Whats that commercial on TV all the time "Would you let your doctor do your job....so don't do his". Simple as that people. Also the current system also takes into consideration other medical criteria. Just because one person is next in line to get an organ if its a known fact that, that organ will be rejected by that persons body it goes to the next person in line and so one. The current system is just fine the way it is. As for the "Most Famous and Most Wealthy" getting organs first, we live in a capitalistic society, money is how the world goes round. My grandfather was on a heart transplant list for the better part of his life before he died, never receiving a heart transplant. My family doesn't have a lot of money and I'm going to miss him greatly, but that doesn't mean that I hate the wealthy or the famous because they had money and were able to pay for a heart. Think of it this way if you were dying and you had millions of dollars would you pay for an organ, think good and hard and be honest with yourself. Because if your not honest with yourself how do you expect others to be honest with you.
How many of you have actually known a recipient of a kidney transplant?
I have known several. In some cases, good people have gone on to lead further productive lives. That is not always the case. A man local to where I live, destroyed his own liver and kidneys by his lifestyle. Donors were found relatively quickly. Was he grateful for another shot at life? Hardly. He remained in his destructive lifestyle and died fairly soon.
I certainly haven't the wisdom to solve this dilemna. But admitting a dilemna exists is crucial. Faulting President Obama because there are not enough organs to meet the demand is witless. Even more so in the face of the hue and cry whenever serious attempts are made to promote healthy lifestyle.
As a society we are well-advised to grow up beyond puerile partisanship and face reality.
My 19yr old nephew's kidneys were donated after a drunk driver killed him to:
A 13yr old boy.
A 38yr old single mother on welfare raising her 2 kids alone.
Paul, I'm sorry for your loss and I'm happy that he was able to save 2 others through his generous gift.
Consider the case of Mickey Mantle.
mantle was a great ballplayer, personally troubled but a great player
None of this matters if you don't register to be an organ donor!!!!
Here's something that should be considered a factor: No one who is not registered as an organ donor for five years or more should be considered for a transplant. So just in case you need an organ, don't even think about it unless you've been willing to give when you didn't need one. Hard rule number 1. That should make everyone register and whittle down the waiting lists.
One, so called Obamacare did not create this - Two, what did create this is making a change so the real change can come about later - if you have the money you will shoot to the top of the list. But when a system is in place to prevent, or try and prevent, favoritism due to $ little steps are needed in order to get the big step. My organs are not going to the rich and famous.
Not that this is related to kidney transplants, but I hear horror stories about liver transplants, you know, about how wealthy celebrities are getting liver transplants after quitting drinking for only a year; they get a liver transplant because they have a new lease on life and then they go back to drinking and ruin the liver. Can this type of thing happen in kidney transplants where lifestyles of the undeserving affect the death of the kidney? If someone lives a life that just ruins the organ, they shouldn't be getting it. I don't know if that is getting close to the death panel fear or not, but if I had a choice, I'd rather my kidney after death went to an middle-aged professor rather than a 20 year old gang-banger any day. Life expectancy is often due to your lifestyle rather than your age.
Unfortunately, this has become necessary due to some recipients not taking care of themselves post-op. Part of the problem is the lack of live donors to ease the shortage. You would be surprised to know that a lot of organ donation groups only focus on getting people signed up to be donors upon death. Yes,I can speak from experience. I was a kidney donor for my wife in 2008. After many hours spent in the waiting area of the transplant center before and after you would be amazed at how many people have eligible donors in their family or group of friends who refuse to help. Funny,if a Dr. told you that you had a diseased kidney,liver lobe or lung lobe and it needed to come out, you wouldn't hesitate, but the possibility to save someone's life makes it impossible for you to do it. If you knew the screening process for recipients or donors in the U.S. you wouldn't even think of suggesting that only those who can buy an organ will get one.
However, the vultures at the insurance companies generally won't cover the live donor's expenses. So unless the recipient or the donor have the cash to cover the surgery to remove the healthy person's kidney, there's no point to signing up to be a live donor unless it's to a friend or relative AND they can afford to spring for $50-100,000. Also, and for all of you who are vilifying the Affordable Care Act, it will stop this practice, but under current insurance policies, a person who has voluntarily donated a kidney (or any other organ) is considered uninsurable. The insurance companies want to make sure that they will never have to cough up any money for that donor's care on down the road. So the price for donating a kidney at this point is your cost to have your kidney removed, cash up front, AND to never be able to get health insurance again in your life. Sorry, but I'd have to not only know the recipient, but it would have to be a close friend or relative. Again, though, I will repeat, the ACA changes this and doesn't allow the insurance companies to continue their rapacious, selfish, money-grubbing practices. Why do you think fuax "news" spends so much time demonizing it---and brainwashing it's low of critial thinking skills viewers to hate it too? Not because of what's actually IN the law, but because they are in the thrall of the "health" insurance companies that will no longer be allowed to prey upon sick and desperate people quite as rapaciously as they are used to doing. We should've gotten rid of the private, for-profit health insurance model long ago. How is it possible, even if you do accept the meme that "the government can't do anything right," which isn't true in the first place, that somehow inserting an unnecessary, for-profit middleman between the patient and the doctor is somehow going to actually improve medical care? The problem with the privatization that is the talking point of the republicans and their propaganda mouthpiece, the right-wing media, is this: Certain services are going to have to be provided for the people, either by the government or private industry. If government performs them, generally the service is available to all, but if private corporations do it, they MUST make a profit, which adds to the overall cost of the service. Thus we create a world in which the wealthy can afford to hire security guards to protect their property and their valuable lives, firefighters to protect their homes, health insurance to ensure that they are able to see a doctor, private schools for their children, etc. While the middle-class and poor won't be able to protect their property or their lives, unless they do so them-selves.sdsssssssssssssssssssssssssssssssssssssssssssssssssssss
I recently underwent the screening process to become a live kidney donor. ALL medical expenses were paid for and covered by the kidney disease patient's insurance. I was never asked for my insurance card. I was advised that their plan would cover me for a period of approximately one year following the surgery and mine would need to kick in if there were problems after that. This is standard from what the doctors told me. Since I had my own coverage in place I was also told that I could not be dropped due to a donation.
Unfortunately for my friend, the screening process is very stringent and while I was a match my kidney output is sufficient for me but just under what they require to donate. It was a very positive process, not only did they evaluate my physical health but also my mental state and reasons for donating.
While I support the ACA, I felt it was important to share the facts about live organ donation and hope that more people will consider it. Most insurance companies will pay and it does not cost the donor at all.
Yes, I agree with CtIndepend. I received a kidney from my lovely donor 10 months ago. I cleared it with my insurance company she tested to be my donor that everything would be covered. Also, most ESRD patients are either primarily covered, or partially covered, by Medicare. It is practice for the ESRD patient's medical coverage to pay for anything the donor has to go through in regards to donating a kidney. (it's been a long time since I've commented - I'm no longer Waiting On The List!)
Trust and believe that a loophole would ensure that the most wealthiest and influential people will receive one before most others. Besides, why shouldn't someone in your family donate to a family member first, especially if all the test proves to be a match..?
that is what it is all about people in gov. first and so on down the list look how pa. gov. caseyr got his transplant in a week of needing it
Actually Bobby, as we learned with Chenney when he received a heart transplant, no matter who you are, if you have the money to pay for everything involved in the process, you will get the organ. It may not seem "fair" but transplants are expensive and have to be paid for somehow and if the person who needs it can actually pay for it the medical professionals will give it to them. Though I completely agree about donating to family.
If people could sell their kidneys there would be no shortage. People can live long lives with only one kidney. I'd say 50% of what an operation costs or $50,000 minimum. If a person who donates one gets in a problem, they move to the front of the line. There is no selling per se to the patient. Just to the organization. That would avoid the rich getting them all. However, like I said, there would be a surplus anyway.
No organization would pay for the organ and then pay for the transplant, it's not financially feasible. Where do you think the organization get the money from? Donations of course, and I doubt they have that much spare cash laying around. And by allowing people to sell their organs you are allowing just the rich to get them. Who else can afford $50,000 for an organ? You would have rich folks preying off of poor folks who would see selling organs as another means to get by but when it comes to them possibly needing an organ later in life they might not have the means of getting one. Not to mention that you are getting into territory of people trying to sell "less than healthy" organs that wouldn't be approved for transplant.
Lower the score the better off you will be for any organ, hip, eye or brain replacement; sorry seniors 50 yrs + you get at least 100 point for being so old. obamacare coming to a clinic near you soon.
If Hillary offered to donate one of her jewels, I'm sure obama would have priority to get it.
It is kind of sad there is a shortage of kidneys seeing how that is one of the few organs of which we have two but can do with one.
In general, wouldn't the patients in the best condition be at the top of the list under these guidelines ?
The top 20 percent of kidneys would be offered to the top 20 percent of patients based on this score, UNOS says. The remaining 80 percent of kidneys would be allocated in much the same way as before.
Welcome to the life of Death Panels. Sara Palin was right!!!!!!!!!!!!!!!!
I feel sorry for the poor schlep that's been sitting on the list for awhile that gets bumped because he's just a bit older than another who just popped up.
I don't think there can be a "right way" to play God.
As an individual who recently underwent a partial nephrectomy last month for renal cancer, I can only hope that it has solved my issue and that I will not need a transplant in the future. I can say that if I was to need one that I am okay with the proposed transplant policy, I'm older and have lived a good life and believe that a younger person should benefit, although I hope that lifestyle is taken into consideration.
Can I sign up to donate organs but
specify who can or can not receive them? I would like mine to go to
someone who makes between $30,000and $100,000 a year ( anyone under
that bleeding hearts will take care of anyone over that can buy one)
also I don't want mine to go to an alcoholic, drug addict or prisoner
or people of other deviant life styles. This is not PC but its my
organs and I should have the right to say who gets them. Can I do
this?
I don't believe you can choose after death, you can if you are alive, like a kidney to a relative or friend
No, you can't choose... There are numerous match criteria and adding complexity of someone choosing say only single 30 yr old mothers would make getting an organ to the right person almost impossible.
And you honestly think the most wealthy won't get the best there is? Morbidity after a transplant is heavily influenced by how much aftercare the person can afford. The bottom line is, and always has been, if you're poor, you're screwed. That is not going to change and anyone who believes it will is seriously deluded.
A lot of people are spouting their rhetorical mouths in these comment boards without any real understanding of why this change is being done and must be done. This new system allows the organ assignment to make considerably more efficient use of a limited and valuable resource while very minimally reducing fairness defined as first-come first-serve. It is truly a way to have your cake and eat it too when it comes to organ allocation.
This has nothing to do with socialist medicine, "death-panels", Obamacare, or any of that half-baked rhetoric. It is an example of the kind of thoughtful improvement of our health system that everyone says they are for--at least, until it's time to put your money where your mouth is.
If people really want to check their half-cooked ideas about this at the door and actually examine the facts behind it (doubtful from some here, but who knows?), I recommend reading up on the ongoing research of Operations Research professor Nikolaos Trichakis from Harvard Business School dealing with this very issue. Read "Fairness, Efficiency and Flexibility in Organ Allocation for Kidney Transplantation".
Oh, and for those who are convinced of people buying their way to the top of the line: They certainly are doing that, but it's very likely they are dealing with black market traders rather than bribing official channels, which has no pretense of fairness in the first place. The official organ allocation process in the US is very strictly audited and controlled, and adhered to even when it is obviously unfair.
You really think Steve Jobs did not pay to get an organ he did not deserve? Obviously he was not a good candidate. A shame an organ was wasted on him - only good thing is he died the miserable death he deserved.
He didn't buy an organ, contrary to what some may think.
What money buys is the ability to be placed on lists in multiple regions with greater availability because one can afford to be at a hospital in that area at a moments notice.