Legacy Transplant Services Leader Discusses Lung Transplant Case

The Oregonian (Front Page, above the fold)

June 13, 2013
William Bennett, M.D. medical director of Legacy Transplant Services, spoke to the Oregonian this week about the Organ Procurement and Transplantation Network’s vote to create a new avenue for children seeking lung transplants after two families filed lawsuits challenging the rules. This vote allowed Sarah Murnaghan, a 10-year-old girl from Newtown Square, Pa with cystic fibrosis, to receive adult lungs on Wednesday that will save her life. However, the transplant has turned upside down the 30-year-old rules and protocols to allocate precious resources for the growing number of people waiting for organs.

Dr. Bennett, a local expert and veteran of kidney transplantation, told the newspaper that Oregon generally fares better than nearby states when it comes to waiting for organs. For example, a kidney transplant means an average two-year wait in Oregon vs. about nine years in the San Francisco area.

Of 887 people on waiting lists in Oregon, 71 people -- about 8 percent -- have been waiting five or more years; it's about 10 percent in Washington and 20 percent in California. Oregon keeps waiting times down in part because of its higher percentage of registered donors -- about 70 percent -- than nationwide -- about 40 percent. People frequently move to Oregon for shorter waitlists even, Bennett says, which introduces a slew of ethical questions about geographic distribution of organs.

Organ supply has never met demand. Compounding the problem is a drop in living donors -- 6,020 in 2011 to 5,870 in 2012. In Oregon, living donors have dropped from 93 in 2008 to 66 in 2012. Living donors mitigate the need for kidneys since people can live with only one.

Dr. Bennett said it is hard to pinpoint the cause of the drop, but attributed some of it to the struggling economy. Although the price of the donor's surgery is covered by the recipient, potential donors may be deterred by other costs.
"If you have surgery you've got to miss time from work and a lot of people in this economy just can't," he said.

Additionally, surgeries are invasive and painful, with an average hospital stay for a laparoscopic kidney donation at around two or three days, Bennett says. However, he said the economy doesn't fully explains the trend.

Campbell said the way the public feels about the organ allocation affects donations.

"If the public perceives that the organ allocation system is unfair, they're less likely to donate organs," he said.

After the court ruling, the national organ procurement network created a special appeals and review system for children under 12 waiting for lungs.

To read the rest of the Oregonian’s story, click here