Hospitals refuse some of the sickest patients who need organ transplants to adhere to standards set by the federal government, according to an article from STAT.
The Centers for Medicare & Medicaid Services introduced transplant standards in 2007 and in the years that followed the number of patients pulled from the waiting list sharply increased, STAT reports. A study published earlier this year by the American College of Surgeons found that more than 4,300 transplant candidates were taken off the lists in the five years after the regulations were created--an increase of 86 percent compared to the five years before the standards were in effect.
Under CMS standards, the success of transplants is tied into its hospital ratings and Medicare funding, according to the article. Surgeries performed on critically ill patients are riskier, so hospitals that do such procedures frequently risk damage to their rankings.
“It’s gut-wrenching and mind-boggling,” Adel Bozorgzadeh, M.D., a transplant surgeon at UMass Memorial Medical Center and one of the ACS study’s authors, told STAT. “If you have a young guy who has a 100 percent chance of dying, but only a 30 percent chance of dying with a transplant, you would say, ‘What the hell, give the guy a chance.’ But if I make an argument like that, I will be under pressure from all these other stakeholders who would penalize me.”
A significant number of donated organs are also thrown out because of the potential risks, according to STAT. More than 3,100 donated kidneys were thrown out last year, according to the article, an increase of 20 percent since the standards were implemented in 2007. Many patients are willing to accept less-than-perfect organs, according to the article, but are rarely given the option.
A number of studies have also raised concerns that organs may be needlessly rejected by hospitals, calling into questions common biomarkers and other criteria used to reject donated organs, according to the article.
CMS relaxed the standards after noting concerns about the number of organs that were being thrown away in response to the regulations. “We are concerned that transplant programs may be avoiding the use of certain organs they believe may adversely affect the program's’ outcome statistics,” it wrote in a May memo revealing the changes.