Sending Office: Honorable Earl Blumenauer
Sign Letter to Halt Harmful OPTN/UNOS Liver Allocation Policy
Deadline TOMORROW (4/12)
Current Signers: Blumenauer (OR), Marshall (KS), Dingell (MI), Bucshon (IN), Lewis (GA), Walorski (IN), Cooper (TN), King (IA), Bishop (GA), Roe (TN), DeFazio (OR), Rogers (AL), Luria (VA), Roby (AL), Hollingsworth
(IN), Fleischmann (TN), Joyce (PA), Rice (SC), Norman (SC), Watkins (KS), Richmond (LA), Higgins (LA), Wenstrup (OH), Kilmer (WA), Scalise (LA), Price (NC), Abraham (LA), McBath (GA), Wilson (SC), Bacon (NE), Schrader
(OR), Banks (IN), Palmer (AL), Graves (LA), Estes (KS), Cunningham (SC), Riggleman (VA), Johnson (LA), Byrne (AL), Davids (KS), Griffith (VA), Carson (IN), Woodall (GA), Baird (IN), Pence (IN), Wittman (VA), Timmons
(SC), Sewell (AL), Brooks (IN), Scott (GA), Brooks (AL), Aderholt (AL), Smith (MO), Walden (OR), Hartzler (MO), Case (HI), Gallagher (WI), Lawrence (MI), Chabot (OH), Johnson (GA), Axne (IA), Palazzo (MS), Bonamici
(OR), Guest (MS), Gabbard (HI)
Please join us in protecting the lives of those seeking liver transplantation by supporting the revocation of a harmful new liver transplant allocation policy.
In December 2018, the Organ Procurement and Transplant Network (OPTN) adopted a new national liver distribution and allocation policy that removes regional boundaries from the allocation methodology. Consequently, organs that were once distributed locally,
will now be sent farther away to areas with lower rates of organ procurement. This policy was changed in response to a lawsuit filed in the U.S. Southern District of New York amid claims that the 2017 evidence-based methodology was illegal. The policy attempts
to reform access for available donors to “establish greater consistency in the geographic areas used to match liver transplant candidates with available organs from deceased donors and reduce geographic differences in liver transplant access.” However, instead
this change will simply move livers from rural and lower income areas of the South, Midwest, and Northwest to big cities with larger populations and more demand.
Organs for transplant are highly coveted, but by OPTN’s own account, this new liver allocation and distribution policy will more than double the median distance that livers travel and result in an overall reduction in the number of transplants nationally.
Fewer transplants manifest as more deaths over time, and we are particularly concerned about the further exacerbation of socioeconomic inequalities through the shifting of mortalities from big cities to rural and low income areas.
In eliminating geographic barriers, large and more densely populated metropolitan areas will have greater access to livers for transplant, despite often times having less efficient organ procurement processes. By simply redistributing organs from high-performing
regions to benefit lower-performing areas, this new policy fails to address the underlying issues, including the national shortage of organs for transplants, and the suboptimal organ procurement practices of some regions.
Once this new policy is fully implemented, our delegation will be competing with larger metropolitan areas who do a poorer job of procuring organs for transplant. Consequently, this policy will disadvantage our constituents, with some analyses predicting
that the number of liver transplants in some areas could decrease by as much as 50%. This drastic reduction in the volume of organs available in certain areas will reduce patient access to life saving health interventions, putting countless lives
Please join us in halting the implementation of this detrimental new liver allocation policy. For further information, or if you would like to sign, please contact Martha Cramer with Rep. Earl Blumenauer at Martha.Cramer@mail.house.gov,
Charlotte Pineda with Rep. Roger Marshall at Charlotte.Pineda@mail.house.gov, Joe McNally with Rep. Debbie Dingell atJoe.McNally@mail.house.gov, or Sarah Killeen
with Rep. Larry Bucshon at Sarah.Killeen@mail.house.gov.
Earl Blumenauer Roger Marshall, M.D.
Member of Congress Member of Congress
Debbie Dingell Larry Buschon, M.D.
Member of Congress Member of Congress
April XX, 2019
The Honorable Alex M. Azar, II
U.S. Department of Health and Human Services
200 Independence Avenue, S.W.
Washington, DC 20201
Dear Secretary Azar:
We write today to urge that you immediately rescind the Organ Procurement and Transplantation Network (OPTN)/United Network for Organ Sharing (UNOS) acuity circle policy adopted in December 2018. This policy, which is currently scheduled to be implemented
on April 30, 2019, would be detrimental to millions of Americans. It is predicted todecrease the number of transplants performed nationally and will especially harm low-income and rural communities.We urge
you to direct the OPTN/UNOS to discontinue efforts to implement the acuity circle policy and, instead, convene the various stakeholders to develop a policy that is formulated to appropriately consider organ distribution that ensures minimal adverse outcomes
associated with socioeconomic inequities, as required by law.
In December 2018, OPTN adopted a new national liver distribution and allocation policy that removes regional boundaries from the allocation methodology. The policy attempts to reform access for available donors to “establish greater consistency in the geographic
areas used to match liver transplant candidates with available organs from deceased donors and reduce geographic differences in liver transplant access.” However, instead this change will simply move livers from rural/low
income areas of the country to wealthier locations without any legal or medical rationale for doing so.
In response to a lawsuit filed in the U.S. Southern District of New York alleging that the use of Donation Service Areas (DSAs) and OPTN Regions in the allocation methodology for donated livers is illegal, the Health Resources and Services Administration
directed OPTN to remove DSAs and OPTN regions from its allocation methodology prior to the OPTN board meeting in December 2018.
Ultimately, the December 2018 policy will not solve the core issues of transplantation in the U.S. – a shortage of donated organs and suboptimal organ procurement practices. The policy will disincentivize organ donation, reduce organ availability in rural
and minority communities, and destabilize local transplant centers. The Department of Health and Human Services should be pursuing policies that promote better organ procurement organization performance in every part of the country, not policies that pull
organs from high-performing regions to the benefit of low-performing areas.
We strongly urge that you immediately rescind the December 2018 policy and exercise your authority by directing the OPTN/UNOS to develop a new policy that achieves the best use of donated organs for all Americans.
We look forward to your reply to this urgent matter.
 SRTR Analysis Report: Data Request on Circle Based Allocation (Sept. 24, 2018), https://optn.transplant.hrsa.gov/media/2640/li2018_01_analysis-report_20180924.pdf.
 UNOS News Bureau, OPTN/UNOS Board approves updated liver distribution system, 4. December 2018,https://optn.transplant.hrsa.gov/news/optnunos-board-approves-updated-liver-distribution-system/.
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