Neighbors exclude Illinois from organ-sharing network
August 19, 1999
BY MARK BROWN, STAFF REPORTER
The Transplant Wars between Wisconsin and Illinois have taken another strange--and possibly deadly--twist.
Concerned that new federal rules would let Chicago hospitals siphon off an unfair share of donated livers, Wisconsin officials are leading a group of states that this week began excluding Illinois from the normal organ-sharing network.
"They're violating every rule known to the transplant community," said David Bosch, spokesman for the Regional Organ Bank of Illinois. "I guess it's more important to them to make a point than to save people's lives."
The four states--Wisconsin, Minnesota, North Dakota and South Dakota--are concerned that transplant programs in Chicago will be able to lay claim to more of the livers from organ donors in their states. They project Illinois could gain 100 donated livers--at their expense--over the next four years.
That's because the Chicago hospitals handle more patients in the most seriously ill category, known as Status 1, who are supposed to get priority under the new guidelines.
Patients are listed in Status 1 if they suffer from sudden, immediate life-threatening liver failure and have less than a week to live.
Dr. Martin Mozes, medical director for the Illinois organ bank, said Chicago typically has six to seven Status 1 liver transplant patients monthly.
The dispute between the states creates the possibility of a transplant candidate dying in a Chicago hospital while waiting for a matching liver, even as a liver that could have been used is transplanted into a relatively healthier patient in Milwaukee or Madison--just because the organ was donated north of the border.
That's exactly what federal health officials were trying to remedy last year when they proposed a system of broader organ-sharing with less emphasis on geographic boundaries. The allocation system historically has given priority to serving patients in the local area from which an organ is donated.
Most of the nation's liver transplant community, including hospitals in Illinois, opposed the changes for fear that it would channel most of the available livers to a few major medical centers, particularly in Pittsburgh.
As a compromise, the United Network of Organ Sharing, a private agency that operates the organ allocation system for the federal government, approved new procedures for sharing within regions. Status 1 patients within a region now get first claim to an organ before it can be offered to a local patient whose need is considered less urgent.
But Wisconsin officials have declared they won't follow the new procedures unless Illinois agrees to a "payback" provision under which it would provide livers to other states in the region if it exceeds a limit.
"We are operating as though Illinois is not in this region," said Dr. Anthony D'Alessandro, University of Wisconsin transplant director.
D'Alessandro said his program is no longer following the normal UNOS procedure of obtaining a computerized list of which patients will be offered an organ first. By not checking the list, D'Alessandro acknowledged he will be skipping over Illinois patients who are in Status 1.
Dr. Michael Abecassis, director of liver transplant at Northwestern Memorial Hospital, said the Chicago hospitals believe a payback provision "goes against the spirit of the sharing agreement."
Wisconsin's organ donor programs are generally rated among the best in the nation in terms of producing organs for transplant, on a per capita basis. That has led to resentment that Wisconsin is required to "export" organs to Illinois, which it accuses of doing a substandard job of organ procurement.
Former Chicago Bears running back Walter Payton, who is waiting for a liver transplant at Mayo Clinic in Rochester, Minn., would theoretically be helped by excluding Illinois because it could make a few more livers available in Minnesota.
So, there's trouble in the land behind the cheddar curtain, it seems.
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To: Prince Charles
No trouble in Wisconsin, plenty of trouble in the corruption filled state of Illnoise.
If Illnoise want more organs then start pushing the organ donor program.
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To: Prince Charles
Thanks. This article goes a long way towards explaining HHS and Shalala's pushing so hard for a national system of organ distribution. I wonder to what extent this consideration has been behind Clinton's Executive Orders on federalism.
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To: Wallaby, T'wit, Budge, Askel5, Bloodhounds
A bump for your attention.
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To: po'boy
Don't tell them that. IL will go to a harvest system to make up the difference.
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To: Prince Charles
Off the top and without any real knowledge of the situation, I'll side with this being bureaucratic hanky-panky. Somebody higher up seems to have invented a rule to enable Illinois to raid its neighbors' supplies of transplant organs. This sort of thing goes on all the time, and it's more to build empire than to save lives. The neighboring states aren't buying this one.
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To: aristeides
Please keep us apprised of such articles. I missed a good one some time ago that I'd clipped and now can't find it.
Regards!
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To: Askel5
I'm sorry. I would have told people here about this article if I had known about it, but I did not.
And I'm not really in a position to know about it. I'm a lawyer in an agency of the federal government in Washington, D.C., and this is an article from a Chicago newspaper that is not directly related to my work. I think you probably have me confused with someone else.
That said, I must say that this is a very interesting article. I have been wondering for some time why HHS wants to federalize the distribution of organs for transplant. This article goes a long way towards explaining that.
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To: aristeides
Well, THANKS then for the article, in any case. (The Blood Trail -- whether it's the spread of Hep-C or the exposing of the Red Cross and the blood industry for the amoral businessmen they really are -- actually goes a long way toward explaining the government's interest in organs. Going to be a long row to hoe.)
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