Although thousands of people require organ transplants every year to address various conditions that cause organ failure, the supply of organs is not nearly enough to meet demand. As a result, people often spend years on waitlists, biding their time until they are lucky enough to receive a compatible organ before their health deteriorates to fatal levels.
Thanks to a policy instituted in the late 1980s, patients can join wait lists for organ transplants in different treatment centers to increase their odds of finding a compatible organ faster. While this policy certainly gives patients a chance to increase their odds of securing a much-needed organ, there have been hot debates on whether the policy is ethical.
Those who oppose the policy state that it grants certain patients, particularly those of a higher socioeconomic class, an unfair advantage over other patients. They say that it allows socioeconomic disparities to flourish in the already-strained organ transplant field. On average, kidney-transplant patients on multiple wait lists get an organ transplant around two years earlier than those listed at one center.
Furthermore, liver transplant patients listed at several centers tend to have lower MELD scores, representing the severity of one’s illness and their position on a wait list, compared to those on one wait list. This shows that the multiple-listing policy allows patients with less severe illnesses to secure organs before patients who have more severe illnesses and need organs faster.
According to the Ethics Committee in charge of organ sharing under the United Nations, the policy on multiple-listing should only be limited to patients who may have a difficult time finding matches. The committee recently published a white paper detailing its recommendation on how the organ transplant field can ensure that the ever-growing pool of organ transplant patients has fair and equitable access to healthy organs.
The white paper presented data showing that higher educated people with insurance are more likely to receive organ transplants via multiple listings. It states that organ transplant patients with less than a high school education have a 50% lower chance of being on multiple wait lists for liver or kidney transplants. The white paper also noted that patients with a post-graduate education have 60% higher likelihood of being on multiple waitlists for kidney and liver transplants.
Medicaid patients are three times less likely to be on multiple lists compared to patients on private insurance policies.
In a recent report, the National Academy of Sciences, Engineering and Medicine stressed that the U.S. organ transplant and allocation system is in dire need of equity improvements in the next five years. Given the shortage of donor organs in comparison to patients that need them, it is sad that many recipients manifest organ rejection once the transplant has been completed. Efforts by companies such as Aditxt Inc. (NASDAQ: ADTX) to find ways to tweak the immune system so that cases of organ rejection reduce are underway and will increase the odds of successful transplantation.
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