But there are scores of patients for whom a local center offers no advantage. Often, even if a patient lives near a transplant center, that center may not have the expertise to treat that patient's particular condition, making it necessary for the patient to seek care elsewhere. Some patients who have financial means may opt to list at another center or multiple centers with shorter waiting lists in order to increase their odds of receiving a transplant. But not all patients have the luxury of choice. Insurance companies often dictate where a patient may go.
Veterans are limited to one of only a few centers in the United States.
Patients who live in the 14 states that do not have a liver transplant program have no choice but to travel out of state. For any of a number of reasons, one in four patients travels out of their state of residence to undergo liver transplantation, according to a recent analysis of OPTN data. Federal regulations that strive to minimize these inequities will benefit all patients, whether they are listed at a small center or a large center. For the first time, there will be equitable access to organs, and it will no longer matter what choices patients make or are forced to make in terms of where they are listed. It is unfortunate that some choose to reduce the arguments in favor or against regulating the transplant system to economic terms.