By Sandy Alexander
WASHINGTON – All eight members of Maryland’s congressional delegation voted against a bill Tuesday that would derail a Clinton administration plan to send more organs to areas where they are most urgently needed for transplant.
The House, on a 275-147 vote, passed the bill that reaffirms the United Network for Organ Sharing’s control over how organs are distributed. In doing so, the House blocked a Department of Health and Human Services bid to exert greater control over the distribution program.
Maryland hospitals had opposed the bill, saying the HHS plan to focus more on need and less on location was more fair.
“Maryland is unique in that we are a real small state, but we have two of the largest transplant programs in the country,” said Christopher Lynch, a spokesman for the University of Maryland Medical System, referring to his group and the Johns Hopkins Hospital.
That leads to an acute shortage of transplant organs in Maryland because people come from surrounding states and across the country to get transplants at the prestigious programs here, said Marion Borowiecki, chief executive officer of the Transplant Resource Center of Maryland. Its territory includes all of Maryland, except Montgomery, Prince George’s and Charles counties.
A broader sharing of organs would make sure they were available to the neediest patients, Borowiecki said, adding that new technology and skilled doctors have made it possible to transport organs farther than ever.
Lynch agreed that HHS’ proposed need-based system would be more manageable than the current one, run by UNOS through a contract with the federal government.
Under UNOS, organ donor systems now first look for compatible local recipients, often within state borders, before looking for possible recipients elsewhere.
But UNOS said the bill only clarifies its relationship with the government, without reducing the oversight that currently exists though contract provisions, regular reports and accounting requirements, said Mark Rosenker, managing director of the group’s Washington office.
Rosenker said that decisions about recipients are made based on need and compatibility as well as location, and there are opportunities to send organs to other areas if no suitable local recipients are found. But considering that organ function begins to deteriorate when it leaves the donor’s body, less travel is better, he said.
The Washington Regional Transplant Consortium, which coordinates transplant activities for Washington and its Virginia and Maryland suburbs, agrees that the current procedure to find a match for an organ is complicated. But “broader sharing to some degree would make some sense,” said Executive Director Lori Brigham.
Brigham was particularly concerned that the House bill seemed to ignore suggestions made by a federal Institute of Medicine study to examine ways to make regional distinctions broader and less arbitrary.
Regardless of their position, members of Congress and local experts agreed that the real key to solving organ donation issues is to increase the number of donors.
Rosenker noted that the House bill includes funding to study organ donation programs and also calls for an increased effort by states to get people to become donors.
But Lynch said the president is opposed to the House bill and has threatened to veto it in its current form. The Senate has not acted on the issue, but is working on a compromise measure.
Borowiecki was pleased that the attention brought to the issue by Tuesday’s floor debate, if nothing else, may raise awareness.
“Whatever happens, we want to make sure everyone gets a fair shot,” he said.
