The availability of an organ becomes the indication for transplantation instead of medical urgency. The allocation system continues to allow the distribution of organs to be controlled by local organ procurement organizations or their transplant centers instead of viewing the organs as a national resource. The system is unfair to patients because of the great disparity in waiting times from center to center. In Massachusetts, the average time a patient waits for a liver transplant is nearly 600 days, while at centers in Alabama, Georgia and Kansas, for example, patients may wait just a couple of weeks. UNOS allows patients to be placed on waiting lists at more than one center so that they increase their chances of receiving an organ, a practice that only verifies the system is inequitable and unfair.
Patients often have little choice in choosing a transplant center.
Referring physicians and insurance companies often dictate which centers a patient must go to. Because the inequities of the current and new policies that allow organs to be captured locally, these patients may not receive organs in a timely fashion and some die as a result. Transplant centers have shown considerable variation in survival outcomes for their patients. Status 3 patients who received transplants had no increased rate of survival two years later than did status 3 patients who were not transplanted, according to a study presented by UNOS at the International Congress of the Transplantation Society this year. Thus, transplantation offered these patients no net benefit of survival.