The University of Kansas Health System is treating a total of 44 COVID patients today, same as yesterday. Other significant numbers:
- 29 with the active virus today, same as yesterday
- 6 in ICU, 5 yesterday
- 1 on a ventilator, same as yesterday
Key points from today’s guests:
Dr. Steve Stites, chief medical officer, The University of Kansas Health System
- Meaningful changes were announced at the federal level to overhaul the process of organ procurement – going out and retrieving organs and then distributing those organs to adapt to a patient in need.
- While this is welcome news, this complex and sometimes contentious conversation over organ allocation is far from over.
- This Modernization Initiative is designed to strengthen accountability and transparency.
- The revamped program promises a performance dashboard detailing organ retrieval, waitlist outcomes, transplants and other data by individual transplant center and organ procurement organizations.
Dan Peters, senior vice president and general counsel, The University of Kansas Health System
- This is really about life and death. In 2018, when UNOS announced sweeping changes in the allocation of donor livers, multiple transplant teams, patients, lawyers, and legislators sounded the alarm of devastating consequences.
- Despite the warnings, UNOS enacted the changes in 2020 that had an effect of disproportionately impacting regions of the country that are high organ donors, so certain areas of the country became more net exporters of organs to other areas.
- Since 2020, 83 percent of the University of Kansas Health System donor livers have been exported to transplant programs in Chicago, Minnesota, Oklahoma, and Texas.
Dr. Sean Kumer, vice president of perioperative & procedural services, The University of Kansas Health System
- Everything we predicted would happen in 2018 with the proposed changes did happen – more than 80 percent of livers donated here are shipped out to other areas.
- That's a big change for our patients – instead of local first, it became national first or regional first, and as a result, we've been net exporters and that hurts our patients.
- UNOS is a private contractor of the government that runs the liver allocation system and they have recently undergone some new leadership.
- Donors can specify a recipient, but they cannot specify a region to be donated to.
- If we have more donations, we have more transplants. We are fighting to focus on getting more donors, who are the true heroes.
Dr. Timothy Schmitt, director of transplantation, The University of Kansas Health System
- We worry about the growing number of organs that are not used, and we believe that is happening because the complexity of the 2020 changes in process.
- For example, if we have a donor here in our area, it gets shipped to Chicago instead of staying local. But if doctors there decide that they can't use it, by that time, it has too much cold time (time outside of the body) and nobody can use it.
- Too few organ donations in many regions is the problem. There are articles that show that if you increase donations nationwide, the number of transplants would have gone up by thousands.
- Changing allocation procedures doesn't fix donation, it just makes things more complex, and it doesn't address the real problem.
- We want a process that is quick, efficient and saves more lives.
Dr. Ryan Taylor, transplant hepatologist, The University of Kansas Health System
- Your MELD score predicts where you will be on the transplant list and the whole process is designed to have the sickest patients first be transplanted – and that's reflected by the highest MELD score.
- Living liver donors are another option, but the donor needs to be healthy to donor part of their liver to someone else.
- We want the public to be aware of these challenges so they can have a voice in how liver allocation is handled moving forward.
Dr. Dana Hawkinson, medical director of infection prevention and control, The University of Kansas Health System
- The World Health Organization’s vaccine experts have revised their global COVID vaccination recommendations, and healthy kids and teenagers considered low priority may not need to get a shot.
- The FDA has not yet weighed in on this yet.
- Younger people are less affected, but it still is recommended that the younger population does complete the primary series and get at least one booster.
- The new reports seem to want to shift prioritization to those higher at-risk populations.
- We continue to see downward trends in hospitalizations, and those who are hospitalized are going to be the most at-risk patients with several comorbidities.
Thursday, March 29 is the next Morning Medical Update. U.S. Assistant Secretary of Health, Admiral Rachel Levine shares new information on long COVID from ongoing research that started two years ago. Admiral Levine is also a pediatrician and will talk about the impact of long COVID on children.
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