Robert Higgins, MD
In the United States, more than 100,000 people are currently on transplant waiting lists for organs, including more than 4,700 people in Illinois. But each year — because of the scarcity of donor organs — less than half of those who need transplants will get them.
“The number of donors simply isn’t keeping pace with the growing need for organs,” says Robert Higgins, MD, chairperson of cardiovascular-thoracic surgery at Rush University Medical Center, who has taken a special interest in organ distribution throughout his career. He is immediate past president of the board of directors of United Network for Organ Sharing (UNOS), which generates and maintains the transplant waiting list, and he is currently a physician liaison on the UNOS Foundation board, which is looking at ways to increase organ donation. He previously sat on the Secretary of Health and Human Services Advisory Committee on Transplantation, which addresses transplant-related issues and concerns at the national level.
In this post, Higgins discusses the state of organ donation today, and what efforts are under way to address the increasing need for donor organs in the United States.
How are organs distributed — who gets them and why?
It’s a very complicated sequence of matching need with the availability of organs. If you have a diagnosis of end-stage heart, liver, kidney or lung failure, as determined by a physician, you are entered onto a recipient list that has certain predefined criteria. Local organ procurement agencies, such as the Gift of Hope in Chicago, help manage the organ donor lists at the local and regional levels. When an organ becomes available, they contact UNOS, which generates and maintains the national transplant waiting list. UNOS then generates a list of potential recipients — the people who are the right blood type, height and weight, and who have been waiting the longest or who are the sickest. The local agency then notifies the physician that the patient is being offered an organ.
Do famous or wealthy people have a better chance of getting an organ?
There is no favoritism in the system as it stands now. These listing criteria and practices and supervision of the process have evolved over the last 27-plus years. So everybody has an equal shot at getting an organ once they get on the UNOS list. Some medical issues do come into play — for instance, heart or liver failure patients who are expected to die within 30 days get priority over people who have chronic stable heart failure or liver disease. But there isn’t any way to jump the list except by the criteria of how sick you are, what your blood type is and how rare it is, and special medical circumstances.
Do lifestyle factors influence who gets organs?
I personally don’t see that our job is to judge people based upon past mistakes, but we are concerned about people who show an inability to change the behavior that led to the organ damage. If a person is actively smoking or drinking, for example, we consider that as a behavior issue that must be changed before that person would be considered for a transplant. There are so many people who would do anything to get an organ that it doesn’t make sense to offer organs to those who aren’t willing to do whatever it takes to improve their health. Patients must also demonstrate compliance with the complex regimens — exercise, medications and diet — prescribed by their physicians. Continue reading