Using the United Network for Organ Sharing (UNOS) database – a nonprofit that manages the US organ transplant system under federal contract – researchers at Columbia University Medical Center in NY looked from 2000 to 2013 and found that by registering with more than one organ transplant center, patients had higher transplant rates, lower death rates while waiting, had more money, and had a better chance of being insured.
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As for the correlation between wealth and multi-listed patients, the research suggests wealthier patients are able to travel further, stay at temporary housing like hotels, and incur other costs that are not covered by health insurance, in order to get themselves onto multiple wait lists. But that privilege appears to favor wealthier patients and may be exacerbating existing inequities in organ transplantation, according to data presented November 9 at the American Heart Association’s scientific sessions.
It is not known if he was on more than one waiting list, however. Insurance may not reimburse for listing at more than one center, as well. The organization has reconsidered the multiple listings policy three times in the organization’s history, he said.
-Median incomes were higher in zip codes where multiple listers lived: $93,081 versus $67,690 for people on just one list. For example, a few advocates at transplant centers might be more likely than others to push for patients to join a second list, Kahn said.
Steven Taibbi, 62, who lives in Huntington on New York’s Long Island, is on a wait list for a heart at Columbia, but he is seeking a second listing in Los Angeles.
The worldwide Society for Heart & Lung Transplantation and the Heart Failure Society of America funded the study. However, for kidney transplants, it may be more likely to have an effect. Should we limit it?
In addition to how sick patients are, wait times for transplants are largely determined by where patients live, Newman said. Organs are usually given to patients locally, potentially making patients wait a long time who are in regions of the country with low availability.
The former Apple chief was on a transplant list in Tennessee and received a new liver at a hospital there in 2009 even though he lived in California. There are 122,000 Americans in need of an organ transplant; however, as of July just 18,000 transplants had been performed in 2015.
Death rates while waiting for an organ were higher among those on a single list versus multiple ones: 12% versus 8% for those seeking a heart; 17% versus 12% for a liver, and 19% versus 11% for a kidney.
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Although the current study could add to this suspicion, it will hopefully bring light to a potential problem and get people talking about how to address it, he said.
