WASHINGTON – The country’s organ-sharing network withdrew its threat Friday to demote Maryland on its kidney waiting-list after the state showed good progress in repaying its “kidney debt” this year.
At its semiannual meeting in Baltimore on Friday, the United Network for Organ Sharing reversed a June decision that would have denied a perfect-match kidney to a Maryland patient if a patient elsewhere also matched.
That change was scheduled to take effect in December, in an effort to prod Maryland to repay its kidney debt – one of the two largest in the country.
Kidneys are the only organs for which UNOS monitors debts and paybacks. If a state imports more kidneys than it returns, it goes into debt.
But Friday, the network amended its debt payback policy to give the state more time to repay its kidney debt. UNOS took the step after Maryland “showed good progress in repaying its organ debt this year,” said Bob Spieldenner, a spokesman for the umbrella network that monitors organ donation in the nation.
UNOS considers any debt above four substantial and Maryland currently owes the network 47 kidneys. But the Transplant Resource Center of Maryland Inc. has been working hard to reduce the debt, which stood at 68 kidneys at the beginning of 1999.
The 30 percent reduction in that number since that showed “outstanding progress,” said Marion Borowiecki, chief executive officer of the center.
Spieldenner said the rule did not originally mean to target Maryland – it was just intended to close a loophole in the network’s organ donation process.
The Transplant Resource Center said the UNOS decision would have penalized needy recipients. At the end of March, 1,714 patients were waiting for a kidney transplant in Maryland. Borowiecki estimated that the number stands at about 1,400 today.
Had the UNOS rule gone into effect, 44 of every 50 potential recipients would be demoted on the waitlist, Borowiecki said.
“It does not pass the common-sense test that patients should suffer for misunderstandings between two organizations,” said Bruce Brooks, a heart recipient and member of the Transplant Resource Center. He called Friday “a great day for all kidney recipients.”
Under the new rule, which Borowiecki described as “a very good compromise settlement,” Maryland can repay its kidney debt over a period of three years. Borowiecki said the state hoped to continue repaying the debt at its current rate.
While Maryland will still have to repay its current debt, the amendment will start a new kidney account for each state on July 1, 2000. Each state will start with a zero balance then and will not be allowed to go more than nine kidneys into debt.
The network’s kidney payback committee will review the repayment annually to make sure states keep up. If a state goes too far into debt, it would be referred to the network’s Membership and Professional Standards Committee, which would consider further action, Spieldenner said.