New liver transplant rules begin amid fight over fairness

WASHINGTON (AP) — Wilnelia Cruz-Ulloa spent the last months of her life in a New York City hospital, waiting for a donated liver that never came. Doctors had urged the 38-year-old to move to another state that has more organs to go around. But she couldn’t afford to.

Where you live makes a difference in how sick you have to be to get a transplant, or if you’ll die waiting. Now the nation’s transplant system is aiming to make the wait for livers, and eventually all organs, less dependent on your ZIP code. New rules mandating wider sharing of donated livers went into effect Tuesday despite a fierce and ongoing hospital turf war in federal court.

But more than a dozen hospitals in parts of the Midwest and South sued to block the change, arguing it will endanger their patients, especially in rural areas, if livers must be shipped further to areas with fewer donations. Late Monday, a judge in Atlanta denied their request to put the rules on hold until the legal challenge is decided. The next day, those hospitals appealed, still seeking to halt the rules after they began.

At a hearing last week, U.S. District Judge Amy Totenberg made clear the debate weighs heavily: “Transplant issues have this life-and-death and emotional dimension that carries over to everyone who is involved.”

More than 13,000 people are awaiting a new liver, according to the United Network for Organ Sharing, which runs the nation’s transplant system. Just 8,250 got transplants last year, the vast majority from deceased donors. On average, three people die every day waiting.

That’s just livers. Overall, UNOS’ registry shows nearly 114,000 people are waiting for an organ transplant.

UNOS pledged Tuesday to evaluate if the new liver rules have the intended effect, acknowledging “this has been a challenging time” of strife between transplant centers.