Should Kansas donated organs stay in Kansas?

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Should Kansans be able to tell organ transplant teams that their organs have to go to someone in state?  That's the question state lawmakers were considering in a hearing Tuesday in Topeka.  It's due to a coming rule change at the national level that could send more donated organs out of state.

"I'd already had the get your affairs in order talk.  Yes, it's time to call your son who's deployed. It's time to do all that. I was at the end of my journey," said Tina Slovak. "In November of 2015, my husband found me non-responsive on the floor in our home and I slipped into a coma.  I was in multi-organ failure at that point, liver and kidneys."

She knows what it's like to need an organ donor.  She nearly died from liver failure four years ago.  On the MELD scale used to determine how bad liver failure is, she was a 34 out of 40.  It took someone else's death to save her life.  She doesn't know who saved her, though, or where they died.  

That's how organ transplants usually work.  And they work a lot in Kansas, with 75% of Kansans registered as organ donors.

"Kansans are generous," said Jan Finn, CEO of Midwest Transplant Network, which handles organ donations in the state.  "The coasts however, California, New York, Boston, are typically not as successful in recovering organs.  But they have a lot of people waiting for transplants."

Which is why the national bodies that govern transplants are changing the rules when it comes to liver transplants starting next month.  Instead of keeping donated organs within a multi-state region, organs will go to the sickest person within a 500 mile radius.  That means Kansas livers could end up in Denver or Dallas. 

"It should be whoever is the sickest person gets that phone call," Slovak says. 

Early  modeling, though, predicts this change will cut in half the number of transplant livers coming to Kansans.

Some medical facilities and Kansas lawmakers don't like that, saying Kansans should be able to designate whether their organs will stay in state.
Slovak says she can see a problem with that idea. 

"Can you imagine Kansas City? Literally across the street is Missouri," she explained.  "So a patient from Missouri, who could live in those houses right across the street, has a MELD score of 34 and mine would have been 23.  And I would have gotten the transplant first because my address is Kansas."

She shakes her head.

"Right now, the system is the sickest person goes first.  And that's really the way my family feels like it should go."

Jan Finn doesn't know if it would be possible to implement a state preferential system for organ donations.

"That is very complicated," she said.  "The way the bill is written, it would be challenging for us... Currently that is not in sync with our national policy."

That national policy allows donors to say they want their organs to go directly to someone, like Dawn Williams recently did with her kidney.  But they need a name and location. 

Williams remains a registered donor for the rest of her organs, should something awful happen.  She says she's not sure what she'd do if given a choice of where those organs should go.

"I really think that would be like a person to person kind of basis.  The decision to be an organ donor is a pretty personal one anyways," she said.  "So, if the option was given to me, maybe I would consider trying to keep it in the state.  But, you know, like I said before, whoever needs it, by all means can have it."

At this point, the Senate Public Health and Welfare committee has heard testimony on the bill.  No word on when or if it might move to the full Senate for debate.