As stakeholders debate organ allocation rules, courts may push change

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The week before Thanksgiving, 21-year-old Miriam Holman breathed through an artificial machine in the Columbia University Medical Center intensive-care unit. Her disease—a rare form of pulmonary hypertension—is incurable and she is in danger of dying soon without a lung transplant.

But she lives in New York, or, in organ allocation parlance, Region 9, which has fewer locally procured organs than most other regions, according to data from the United Network for Organ Sharing.

UNOS, the private, not-for-profit organization in charge of the organ transplant system, divides the country into 11 regions, essentially demarcating borders within which organs move from donor to recipient.

The first legal challenge to the borders in years hit Nov. 19, in Holman's name, spurring an almost-overnight change by the gridlocked organization.

Attorneys filed an emergency complaint against HHS on her behalf. They sought an injunction on UNOS' regional policy that is much-debated but seldom changed

The Holman lawsuit set in motion a rapid succession of government counter-appeals and new court orders. It culminated in a Thanksgiving-weekend change to a rule on lung allocation, expanding the procurement area to a 250-mile radius around a patient's donor service area. Continue reading