UK HealthCare

Op-Ed: For Patients Awaiting a Life-Saving Organ Transplant, Help is on the Way

Malay Shah

LEXINGTON, Ky. (Dec. 8, 2020) — Despite nearly 33,000 people receiving a life-saving organ transplant in 2020, almost 110,000 are awaiting a second chance in life. According to a recent Bridgespan report, 33 people die each day waiting for that gift of life.

In Kentucky, 960 people are awaiting an organ transplant. The majority of transplants occur after an individual has died and their family makes the courageous choice to donate organs to save other lives. Unfortunately, the gap between donors and patients in need of an organ transplant continues to widen.

Instrumental in helping people awaiting transplant are organ procurement organizations (OPOs). These are 58 nonprofit government contractors on the front lines of organ donation and charged with identifying potential donors.

Sadly, research has suggested that 28,000 organs go unrecovered each year. Many OPOs are underperforming in their efforts to identify donors in part because they have minimal regulatory oversight and have largely operated as monopolies. Although OPOs such as Mid-American Transplant in St. Louis, and OurLegacy in Maitland, Florida, are some of the highest performing OPOs in the country, many other OPOs do not have the same progressive leadership or results.

However, the days of unregulated OPO performance are finally coming to an end. In December 2019, the Centers for Medicare & Medicaid Services (CMS) proposed regulations to hold OPOs accountable to patients and to those who donate organs. Research that I and colleagues around the country have conducted has demonstrated that objective and verifiable data can help OPOs identify potential organ donors. This data can also be used to compare the performance of OPOs in a rational and standardized way.

As expected, there was pushback from the OPO industry and the Association of Organ Procurement Organizations with stories of how these regulations would lead to the demise of organ donation, transplantation and deaths. The fact is that it is simply untrue that lives would be lost because of increased regulatory scrutiny.

Fortunately, CMS was not moved by these horror stories not based on scientific data or fact. On Nov. 20, 2020, regulations were finalized that will hold OPOs accountable to performance standards.

It is a significant milestone in the history of organ donation and transplantation. I have no doubt that in 10 years the transplant community will look at this as the day our entire field changed in a positive manner. I look at this day in which many years of hard work and perseverance in both research and advocacy efforts finally paid off. In some ways, I look at this as an accomplishment of my life’s work, yet also as a new beginning for the lives of many patients.

I would like to thank UK HealthCare and the University of Kentucky Department of Surgery for their endless support of our transplant center and the patients we serve. And I would be remiss in not thanking Kentucky’s congressional delegation to the U.S. House of Representatives and the U.S. Senate for their efforts in listening to the concerns of UK HealthCare, the UK Transplant Center, and most importantly, our patients.

Specifically, I want to recognize U.S. Senate Majority Leader Mitch McConnell for his willingness to take an active role in the transplant and donation processes at the federal level. He and his staff have been engaged with this process from the beginning and have been advocates for the patients we serve.

Malay B. Shah, MD, FACS is the Surgical Director of the Liver Transplant Program at UK HealthCare

The University of Kentucky is increasingly the first choice for students, faculty and staff to pursue their passions and their professional goals. In the last two years, Forbes has named UK among the best employers for diversity, and INSIGHT into Diversity recognized us as a Diversity Champion four years running. UK is ranked among the top 30 campuses in the nation for LGBTQ* inclusion and safety. UK has been judged a “Great College to Work for" three years in a row, and UK is among only 22 universities in the country on Forbes' list of "America's Best Employers."  We are ranked among the top 10 percent of public institutions for research expenditures — a tangible symbol of our breadth and depth as a university focused on discovery that changes lives and communities. And our patients know and appreciate the fact that UK HealthCare has been named the state’s top hospital for five straight years. Accolades and honors are great. But they are more important for what they represent: the idea that creating a community of belonging and commitment to excellence is how we honor our mission to be not simply the University of Kentucky, but the University for Kentucky.