Moran, Blunt demand HHS overturn national liver allocation policy

U.S. Sens. Jerry Moran (R-KS) and Roy Blunt (R-MO) are calling the relationship between the United Network for Organ Sharing (UNOS) and organ procurement organizations collusion following the release of internal communications between the groups regarding the national liver allocation policy, which they now want overturned.

“These newly released emails are disgusting and absolutely unacceptable,” said the senators in a Dec. 21 joint statement. “They show clear collusion by UNOS and several organ procurement organizations prior to the liver allocation policy being announced, leaving no doubt that the liver allocation policy must be overturned.”

Sen. Moran and Sen. Blunt said that from the time the changes to the national liver allocation policy were first announced three years ago, they raised the alarm about major flaws in the policymaking process.

At that time, UNOS, which contracts with the U.S. Department of Health and Human Services (HHS) to oversee a uniform national policy to ensure fair allocation of donated organs, overruled the Liver and Intestine Committee, excluded certain public comments in the deliberations, and arrived at an outcome that the senators said was radically different from the decision previously reached. 

“What we learned today is that the process was not simply flawed, it was deliberately designed to deny patients in the South and Midwest their fair chance at a lifesaving liver transplant,” said the senators in their statement.

The liver allocation policy changed from a system that, in general, offered donated livers first to the sickest candidates within the fixed boundaries of a donation service area or region to a system based on a candidate’s level of illness and distance from the donor hospital, according to the Government Accountability Office.

UNOS, which sets organ transplant guidelines, in November failed to block the release of its emails that were attached to pleadings in a case contesting the new liver allocation policy. The U.S. Court of Appeals for the Eleventh Circuit ruled that the emails were judicial records, and that UNOS did not show good cause to keep them from being made public.

The emails in question were released in response to the court’s Nov. 17 ruling against UNOS that found UNOS “repeatedly failed to live up to its production obligations” to release documents in ongoing litigation, and acknowledged that the documents show “personal opinions about the relative merits of living in different regions of the United States.”  

The senators say that the emails show a pattern of collusion between UNOS and others prior to the changes in the liver allocation policy being announced. The changes favored certain states at the expense of states in the South and Midwest, which are predicted to see a substantial decrease in organ availability, they said. 

The emails also include profane and disparaging comments about people living in the South, demonstrating a clear bias against these areas in the policymaking process, according to the lawmakers.  

“UNOS tried to use the legal system to cover their tracks. Thankfully they were unsuccessful and their callous arrogance has now been laid bare,” said Sen. Blunt and Sen. Moran in their joint statement. 

“We have repeatedly said the process and policy for determining liver allocations needs to be made fairly and transparently,” added the lawmakers. “Neither UNOS nor the Department of Health and Human Services have lived up to this standard. These emails perfectly illustrate our biggest fears and what we’ve known all along – that the process is totally biased and fundamentally flawed.”

They want HHS to “immediately reverse its implementation of the misguided liver allocation policy.”