It’s an unfortunate fact that more people are in need of organ transplants than there are available organs. According to the Department of Health and Human Services, the Trump administration is issuing a new proposed rule to help address this problem.
The rule will tighten the reporting requirements that Organ Procurement Organizations report on organs that are available for transplant. Currently OPOs self-report to the Department of HHS, but many underperform. The new rule will require that HHS monitor the OPOs to ensure that all available organs are evaluated and are ready for transportation to recipients. The Trump administration anticipates that the new rule will make another 5000 organs of all types available for implants each year, saving numerous lives.
The new reporting requirements would involve two metrics.
The first involves donation rates from patients who die before the age of 75 and whose cause of death does not preclude liver donation. The second involves transportation rates, that is to say the number of organs that are transported to a patient in need of a transplant.
All OPOs that meet the top 25 percent performance according to donation and transportation rates will be publicly identified. OPOs will be re-certified every four years with evaluations taking place every 12 months. The idea is that if problems are identified they can be corrected in a timely fashion.
The second rule will involve people who are willing to donate kidneys or parts of their livers. According to the Department of HHS:
“The President’s Executive Order on Advancing American Kidney Health emphasized that supporting living organ donors can help address the current demand for kidney transplants. HRSA’s proposed rule would expand the scope of reimbursable expenses for living donors to include lost wages, and childcare and eldercare expenses for those donors who lack other forms of financial support. This proposal could increase the number of transplant recipients receiving a better quality organ in a shorter time period from living donors. In general, recipients of kidney transplants from living organ donors have better clinical outcomes than those who continue on dialysis or those who receive a deceased donor kidney transplant. HRSA also is reviewing a notice that would increase the income threshold for living donors eligible for reimbursements.”
Kidney transplants are quite common. According to the American Kidney Fund, candidates for kidney transplants generally are about to experience total kidney failure or else have already done so and are being sustained by dialysis. People who receive kidneys from living donors tend to live longer than those who receive them from donors who have already died, 15 to 20 years as opposed to 10 to 15 years.
The rule would also apply to people who donate parts of their livers. Partial liver transplants involve extracting part of a liver from a healthy donor to a patient who is experiencing liver failure. The partial livers in each person eventually grows to a fully functioning liver.
People with kidney disease and liver failure have to go on a transplant waiting list because far more people are in need of transplanted kidneys and livers than are available. 20 Americans die every day while waiting for all types of organs. The new rule is designed to decrease that number and save as many lives as possible.
Being a kidney or liver donor can prove to be a financial burden, especially for people who have responsibility for children or for older parents. Recovery time for both donors and recipients is measured in weeks, which means a considerable amount of lost income The new Trump administration rule is designed to increase the number of people willing to give a kidney or a partial liver by lightening that burden.
The United Network for Organ Sharing noted that 36,500 total transplants took place in 2018. Of that total, 29,780 were from deceased donors and 6,849 were from living donors. If, as anticipated, the new rule increases the number of organs available over all, especially from living donors, that many more lives will be saved. The new rule is designed to go into effect in 2022, after a comment and evaluation period.