♪♪
amna: The Biden administration
announced plans today to
overhaul the network that has
run the nation's organ
transplant system for nearly
four decades.
The united network for organ
sharing, known as unos, has
faced criticism for inadequately
managing the process.
In 2022, doctors performed more
than 42,000 transplants in the
U.S., but there are still
104,234 men, women and children
currently on the organ
transplant wait list.
Every 10 minutes, another person
is added to that list.
17 people die every day waiting
for an organ transplant.
The proposal would open up a
competitive bidding process for
other organizations to possibly
take over the network, with a
goal of shortening wait times
and saving lives.
To help us understand why this
overhaul is crucial, I'm joined
by Dr. Jayme Locke, director of
the division of transplantation
at the Heersink school of
medicine for the university of
Alabama in Birmingham.
Dr. Locke, thank you for joining
us.
There is a lot the
administration's plan seeks to
do but at the heart is breaking
up this network that has
operated like a monopoly for
almost 40 years.
Help us understand how it came
to be that way in the first
place.
Dr. Locke: Thank you so much.
In many ways, it has been that
way because there has been a lot
of inertia to overcome.
It reflects how the national
organ transplant act was written
and some of the requirements
there are in terms of
administering the contract.
It is great to see a desire to
reflect on where we are and how
we can get better so we can help
our patients.
Amna: The system relies on a
network of more than 50 local
organizations to both procure
the organs and help manage the
transplant process.
That network is responsible for
increasing the number of
transplants performed over the
years.
Critics say that system has led
to vast inequities.
Where have you seen that show
up?
Dr. Locke: For us in the
southeastern U.S., when you look
at things like kidney disease,
there is no question that
recently we saw an increase in
the number of transplants but
that reflects sadly on the
opioid crisis.
What the numbers do not reflect
is the results of some of the
new allocation systems.
Currently due to inefficiencies
and logistics, 1 in 4 kidneys
are actually discarded in the
U.S., or not transplanted.
That is 25%.
Those are lives that could have
been saved.
Amna: There is the issue of the
wait list, as well.
There have been previous
attempts to fix the system.
HHS pointed out black people
were four times more likely and
Latinos were 1.5 times more
likely to have kidney failure
but are less likely to be on the
transplant waits lists.
Why is it so hard to get on the
wait list in the first place?
Dr. Locke: Simply put, you have
to have resources to complete
your evaluation to make it to
the waiting list.
There are about 700,000
Americans that have kidney
failure.
Fewer than 100,000 are currently
wait listed.
That certainly
disproportionately impacts
people who self identify as
African-American or black.
Social determinants of health
drive this.
Individuals who are from areas
of high social vulnerability --
to achieve transplant.
Amna: Dr. Locke, you are on the
front lines of this everyday.
When you look at this plan, do
you believe a competitive
process can help fix the system?
Dr. Locke: I think it certainly
can and it can't hurt.
There is nothing worse than
going to clinic and evaluating
patients and knowing that even
though the patients that qualify
for wait listing will die before
we can offer them a transplant.
We know transplants are
lifesaving, life-giving.
They are associated with
substantial lifesaving benefit.
In many cases, organs are being
discarded from logistical
challenges.
Organs can only be out of the
body for so long.
They can only be on ice for so
long before they are no longer
good enough to transplant.
No matter how good of a
transplant center is at doing a
transplant, if they do not get
what they need quickly enough,
the game is over.
Anything that can help our
system get better, to be more
efficient so we can help those
individuals waiting, that is a
win.
Amna: There are more than a
hundred thousand people
currently on that waitlist.
What does this proposal mean for
them?
Dr. Locke: My hope is they have
a renewed hope for the
opportunity to achieve the gift
of life in the form of a
transplant.
My hope is it gives them a
voice.
This is the Biden administration
and the senate and house saying
we need to do better.
We need to do more for these
individuals who have been
waiting.
To let them know they are not
forgotten and we need to do
better collectively to help them
achieve this extraordinary gift
of life.
Amna: That is Dr. Jayme Locke
joining us from the university
of Alabama at Birmingham.
Thank you for joining us.