Budget cuts stop Phoenix man from getting new liver, Phoenix, Arizona
By Michelle Ye Hee Lee, The Arizona Republic



PHOENIX — A liver-disease patient missed his opportunity for an organ transplant Tuesday, becoming the most dire example yet of an Arizonan denied life-saving medical care because of budget cuts to the state's health-care system for the poor.

Francisco Felix, 32, of Laveen, Ariz., was in the hospital ready to receive a liver that was donated to him late Monday night. But the liver went to another recipient Tuesday morning because he couldn't find $200,000 overnight to pay for the liver transplant, one of seven kinds of transplant surgery the state stopped covering Oct. 1.

Felix was the first liver-transplant patient known to be affected but is not likely to be the last.

Of the about 100 Arizonans enrolled in the Arizona Health Care Cost Containment System who are awaiting transplants no longer covered, 60 of them are candidates like Felix with liver disease related to hepatitis C. Transplant is their only cure.

Last month, Goodyear, Ariz., leukemia patient Mark Price became a poster child for the impact of the budget cuts after his doctor found donors who matched his bone marrow a day after Price lost coverage. Price's story gained attention nationally and an anonymous donor later covered all costs for his surgery.

Because bone marrow comes from living donors, the donated marrow was able to be used at a late date.

It's a different story for liver-transplant patients.

The chances of finding a liver donor are slim because these transplants usually are livers from deceased donors and the demand far exceeds the supply.

If a donor is found, the surgery must take place in less than a day.

Patients who lost transplant coverage have been allowed to stay on the waiting list, but when a match is found they are faced with a ticking clock to come up with up to half a million dollars to pay for the procedure.

Francisco's story

Monday night, Felix's wife received a call from a family friend whose wife was nearing death and wanted to donate her liver to Felix. Their organs matched, and doctors prepared Felix for a surgery set for 10 a.m. Tuesday.

Banner Good Samaritan Medical Center gave Felix until that time to come up with the money for his surgery.

Despite efforts to reach out to the media and the public, the family could not raise the money. Felix was discharged from the hospital and his liver went to the next patient on the waiting list.

"It was his day today. If we had the money, someone to pay for it, he would have received the liver," said Flor, Francisco's wife. "How can people make this decision? How does one person have the right to decide who's going to live and who's not?"

At least 23 low-income patients at Banner Good Samaritan are waiting for transplants, hospital spokesman Bill Byron said.

Byron said patients must meet three criteria before receiving transplants: They must be healthy enough for a transplant procedure, they must have a network of people who can support them after surgery and they must be able to afford the surgery.

Patients who can't afford the surgery after finding a match are placed on a hold list until they can pay for it.

Flor Felix has applied to the National Transplant Assistance Fund so that the family can raise money for her husband's surgery. Byron said doctors believe Francisco will be healthy enough to receive a transplant if another match comes along within the next year or two.

According to United Network for Organ Sharing, a national nonprofit that is contracted with the federal government to manage the U.S. organ-transplant system, the average wait time for a liver is 796 days. Francisco has been on the waiting list since April and only got this chance so quickly because the family friend wanted to donate to him.

Budget cuts

Arizona legislators earlier this year decided to stop paying for certain transplants based on analyses by the Arizona Health Care Cost Containment System.

Certain kinds of pancreas, lung and bone-marrow transplants are among those no longer covered.

The state agency stopped covering liver transplants for hepatitis C because of the procedure's low long-term success rate.

According to the agency, studies showed that when a patient with hepatitis C receives a liver transplant, the virus can infect the new liver within 24 hours. The virus returning is the No. 1 cause of the new liver failing, according to the analysis.

But according to the national transplant organization, transplant is the best treatment option for patients with end-stage liver failure.

Following the public reports of Price's transplant story last month, state lawmakers asked Gov. Jan Brewer to reconsider the cuts. Tuesday, a group of Democrats asked again.

But Brewer's spokesman, Paul Senseman, said the governor would not consider a special legislative session unless someone proposes a way for the state to make up for the $1 billion gap in the agency's budget.