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Organ transplant policy places no limit on number of foreign patients

| Saturday, Sept. 13, 2014, 9:57 p.m.

The National Transplant Act of 1984 specifies that only medical criteria, not citizenship, can determine who receives an organ.

“National organ allocation policies do not offer preference to patients who come from other countries,” said Martin Kramer, communications director for the Health Resources and Services Administration, which oversees organ procurement and transplants for the government.

Until 2012, any program performing more than 5 percent of its transplants on foreign patients was subject to an audit — although none was audited, according to the American Journal of Transplantation.

“There was never any action or any consequence for anyone going over 5 percent,” said Dr. Gabriel Danovitch, former chair of the international relations committee of the United Network for Organ Sharing.

The committee changed its rule to eliminate confusing terminology and determine whether international patients specifically came to the United States for transplants. UNOS approved the revised policy, with no limit on foreign patients, in June 2012.

“We're not Immigration people. Transplant centers aren't designed to examine passports and visas and green cards. ... What we need to know is: Do you live here or not?” Danovitch said.

The changes in terminology make comparisons with earlier years impossible, according to UNOS.

The 2013 data show that most people from other countries seeking transplants in the United States are awaiting kidneys and livers. Among 58,693 new people on the wait list last year, 617 were nonresidents, or about 1.1 percent. Of those, 245 came here specifically for transplants.

“The impact on patients awaiting transplants in the United States is just being examined now,” said Dr. Francis Delmonico, a professor of surgery at Harvard University.

Luis Fábregas is Trib Total Media's medical editor. He can be reached at 412-320-7998 or lfabregas@tribweb.com.

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