June 25, 2009
Availability makes Tennessee a top destination for transplantsApple CEO's surgery raises state profile
By Chris Echegaray
THE TENNESSEAN
If an organ transplant candidate is flexible and owns his own jet, Tennessee can be an attractive place to get a liver.
Organ procurers are exceptionally gifted at getting relatives to donate a dying person's liver, the workers and transplant experts say, and relatively few Tennesseans are waiting for them. Of the nation's 58 organ procurement organizations, Tennessee has landed in the top five in receiving organs for the past several years.
That's probably why Apple founder Steve Jobs skipped over his home state of California's 3,474-person waiting list and got on Tennessee's 229-person list to get his liver in Memphis two months ago.
Registering in multiple states isn't rare for those who can afford to recover far from home, and it increases the chance of finding a match, said Dr. Michael Porayko, medical director of liver transplantation at Vanderbilt University Medical Center.
"I think most of the interest is why would someone from some distant part of the country do that, and it's clear," Porayko said. "Realistically, somebody who has the ability, means and access to a jet can travel a fair distance in hours."
"… I would say kudos to organ procurement services here. They are skilled at talking to families in difficult times and making sense of the gift of organ donations."
Porayko pointed to larger cities — Los Angeles, Philadelphia, and New York — as having relatively few donors for the number of people on a waiting list. And it's one of the reasons people register with multiple transplant units.
Last year, there were 206 livers transplanted in Tennessee, with most of them donated to Tennessee Donor Services in Nashville or a similar agency in Memphis, said Jennifer Griffith, spokeswoman with Tennessee Donor Services.
"Our motto is every donor, every organ, every time," Griffith said. "When you take into consideration the intricate matching system and everything that has to fall into place, it's a miracle, to me, every time a transplant happens."
The median wait for liver transplant patients at Methodist University Hospital — where Jobs had his surgery — is four months compared with 27 months at University of California at Los Angeles Medical Center, according to 2007 data from the Scientific Registry of Transplant Recipients.
Medical need trumps all
Did Jobs bump a Tennessean out of the way for his operation?
"Bottom line — it's not who you are or the money you have," Griffith said. "It's medical criteria under the UNOS (United Network for Organ Sharing), and the number it generates doesn't know who you are. It's height, weight and a lot of factors."
The Model for End-Stage Liver Disease is a numerical scale to measure illness with a score ranging from 0 to 40 — the most gravely ill — for patients 12 and older, said Anne Paschke, spokeswoman for the United Network for Organ Sharing, which runs the nation's transplant system. People with the highest scores typically get organs first.
Dr. James D. Eason, program director and chief of transplantation at Methodist University Hospital Transplant Institute, posted this statement on the hospital's Web site: "He (Jobs) received a liver transplant because he was the patient with the highest MELD score of his blood type and, therefore, the sickest patient on the waiting list at the time a donor organ became available. Mr. Jobs is recovering well and has an excellent prognosis."
One Tennessee transplant recipient said the Mac genius just proved his smarts once again by coming to the state.
"I don't blame him," said Barry Dotson of Murfreesboro. "If I were back in his position, I would've also registered with two or three different states. Thank goodness he did that. He maybe wouldn't be here today."
Dotson received his liver on Feb. 6, 2008, at Methodist in Memphis and is fully recovered.
http://www.tennessean.com/apps/pbcs.dll/article?AID=/20090625/NEWS07/906250360&template=printart
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