Dr. Deepali Kumar (University of Toronto, Director Transplant at University Health Network) was reflecting on his outgoing year as president of the American Society of Transplantation.   Basically, despite all the improvements made over the past 70 or so years, we still have a limited organ supply that restricts the best long term outcomes.

And, although I always talk about kidney transplants, our system also covers hearts nd other organs.  4000 heart transplants were completed in 2022.  And, that’s not enough.

It’s why the Biden administration plans to revamp our transplant system.   It’s been suggested that the UNOS data management approach be totally scrubbed out of the system.  Instead, a patient centric system, where all donor and recipient data  is shared and usable, be created instead.

So, it’s even more traumatic when UNOS and Buckeye (one of the larger transplant centers in the USA) continue their legal struggles concerning access to the transplant databases.  Because all that will do is further restrict transplantation.  And, with some 100K folks on the waiting list with 22 dying each die before they get a transplant, with organs discarded and never used, it’s not surprising that there has been a push to change the way the system works.  (As we have stated, Buckeye plans to bid on the UNOS contract once the UNOS contract is put up for re-evaluation.)

And, I’m not certain that the newest development is all that great either.  Instead of litigation between UNOS and Buckeye, the parties have agreed to arbitration.  (It has been my experience that arbitration does not always achieve the optimal outcome.)

The arbitration process was chosen because UNOS claims that its rules require arbitration.   The clock is ticking- this arbitration process has a two month timeline to develop a solution.

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