A Statement from LifeGift CEO Kevin Myer on the Recent NY Times Article on Organ Allocation

Yesterday, the NY Times released a story it has been working on for several months focused on organ allocation practices; specifically out of sequence (OOS) allocation which occurs when an organ is allocated outside of the sequence of the waiting list, generally because the organ is in imminent danger of not being transplanted. LifeGift is mentioned in the article in reference to the allocation of a kidney that occurred in April 2024; LifeGift CEO Kevin Myer is also quoted in the story.

Out of sequence allocation has been on the rise across the country in recent years, a reflection of the effort to combat the increasing rate of organs recovered for transplant but not transplanted, which is defined as the organ nonuse rate. Increased OOS allocation is also a consequence of Medicare’s (CMS) revised outcome measures for organ procurement organizations (OPOs), which places the accountability for ensuring donated organs are transplanted squarely on OPOs without consideration of the fact that transplant centers are responsible for the acceptance of organs for transplant.

The New York Times story delves deeply into the practice of organ allocation; the reporter visited organ procurement organizations over the course of his research, including LifeGift, and the article accurately highlights OOS allocation as a growing issue in donation and transplant. However, the story omitted several details regarding the case involving LifeGift, and we feel overall the piece did not fully capture the complexity of organ allocation and acceptance, including the transplant center’s role in organ acceptance and accountability for the organ nonuse rate.

The details of the case referenced by the New York Times involved a multi-organ allocation of a kidney and pancreas. Allocation of multiple organs intended to be transplanted together in the same recipient can be challenging, as multi-organ allocation is prioritized above single organ allocation but is vulnerable to logistical complexities and evolving medical suitability of the organs for transplant. In this circumstance, LifeGift followed policy to allocate the kidney and pancreas together. Nine hours after organ recovery, both organs had been sent across the country and the pancreas was determined to be unable to be transplanted. The kidney had accrued significant cold ischemic time, meaning that the organ’s functionality could have been compromised by the amount of time the kidney was outside of the body. A clinical decision was made that the kidney was in danger of being discarded and the transplant center who originally accepted the kidney and pancreas was provided a back-up offer for the kidney to ensure the kidney could be transplanted, which it was.

The New York Times article brings visibility to the challenges of multi-organ allocation and the rise of OOS allocation; a problem that ultimately needs to be addressed in OPTN policy and in the CMS regulations that currently assign responsibility to the OPO for the rate of organs transplanted; a practice over which the OPO does not control. All of the stakeholders who play a role in donation and transplant want to see organs allocated and successfully transplanted in the patients with the greatest need. That is the driving force for LifeGift employees working 24 hours a day serving this mission. We remain hopeful for change in the system driven by thoughtful analysis of practices and accountability while continuing to work with compassion, diligence and transparency in all that we do.