U.S. hospitals are increasingly discarding less-than-perfect organs, denying the sickest patients on organ waitlists lifesavings transplants out of fear poor outcomes will yield worse federal performance ratings, according to STAT.
Adel Bozorgzadeh, MD, a transplant surgeon at UMass Memorial Medical Center in Worcester, coauthored a study that found a sharp rise in the number of people dropped from organ transplant waitlists since the federal government began imposing transplant standards in 2007. The standards are tied to federal hospital ratings and Medicare funding, and hospitals' ability to meet these standards also influences their reputation in the broader medical community. Because surgeries involving extremely ill patients are riskier, hospitals have been avoiding them to protect their performance on the standards, according to the report.
Dr. Bozorgzadeh's study, published in April by the American College of Surgeons, found the increasing reluctance to perform organ transplants on the extremely ill is directly linked to the onset of the standards. Between 2007 and 2012, more than 4,300 transplant candidates were removed from hospital waiting lists, up 86 percent from the five years prior to the regulation, according to the report.
The number of organs being thrown away has also increased out of fear that imperfections could lead to bad outcomes. In 2015, 3,159 donated kidneys were tossed, up 20 percent from 2007, according to federal data cited by STAT.
Soon after Dr. Bozorgzadeh's study came out, CMS changed its transplant standard benchmarks to give hospitals more leeway. However, the system continues to undermine one of transplantation's fundamental principles, according to STAT: the sicker the patient, the higher he or she moves up on the wait list for donated organs.