美国国家公共电台 NPR New Organ Transplant Rules Mean Livers Ship To Sickest Patients Not Nearest

 

AUDIE CORNISH, HOST:

A new system for allocating¹ donated livers to sick patients went into effect this morning. The intent is to make organ transplants more fair nationwide, but transplant centers in the South and Midwest are fighting it. Blake Farmer of member station WPLN in Nashville explains why.

BLAKE FARMER, BYLINE²: Karen Wells wheeled her husband into the ER at Vanderbilt University Medical Center last year, praying for a miracle. He was so jaundiced he was almost unrecognizable.

KAREN WELLS: He was dark - very dark. I mean, there was no whites to his eyes. They were orange.

FARMER: The doctors said it was time to make funeral arrangements. His body was rejecting his first liver transplant.

K. WELLS: It's a miracle, honestly, to get two...

FARMER: Two livers for one patient. It was a long shot, but fortunately, Wells lived in Tennessee, where the waiting list was shorter than on the East and West coasts. For decades, livers were donated to patients nearby, no more than a state or two away. But under the new rule, a liver must be matched with the most critical patient within 500 miles. That means a liver donated in Nashville could end up in Chicago. Brian Shepard leads the agency that oversees³ organ sharing. He says the new rules should save lives.

BRIAN SHEPARD: Targeting the livers towards those folks who are really the most critically ill will result in fewer people dying on the waiting list.

FARMER: But that seems unfair to transplant centers in the South and Midwest, where organ donation rates are higher. More people there sign up to donate, and they also die more often in ways that allow their organs to be used, like from a stroke. The old regional discrepancies⁴ meant some patients could game the system. When he needed a liver, Apple founder⁵ Steve Jobs even bought a house in Memphis.

SANDY FLORMAN: He didn't do anything illegal, but he took advantage of a system because he was able to, financially.

FARMER: Sandy Florman is transplant director at Mount Sinai Hospital in New York City, with one of the longest waiting lists in the country.

FLORMAN: The problem is it's turned into a turf battle. These are very profitable hospitals, and people are afraid that their programs will not do well.

FARMER: A dozen transplant centers sued to stop the policy from taking effect, including Emory, University of Michigan and Vanderbilt. But all they got was a few extra weeks. Seth Karp is Vanderbilt's transplant director. He predicts unexpected delays because many more hospitals will now have to weigh in when a liver becomes available.

SETH KARP: The more complex the distribution scheme is, the more chances you have of not using the liver.

FARMER: Karp estimates Vanderbilt will perform 20% fewer transplants and may have to downsize. And he worries about smaller centers.

KARP: The - if the program in Mississippi closes, if the program in Iowa closes because of this, that's a real national public health problem.

FARMER: I asked Jeffrey Wells, the patient who was near death at Vanderbilt last year, what he thought. He did get that second liver transplant, benefiting from the shorter waiting list.

JEFFREY WELLS: And I'm eternally grateful.

FARMER: Wells actually supports the new rule.

J. WELLS: I mean, I'm like this. When a person decides to be a donor⁶, I don't feel like they're becoming a donor to save one particular person's life.

FARMER: But the transplant centers that sued say they'll keep up their fight in the courts. For NPR News, I'm Blake Farmer in Nashville.

CORNISH: And this story is part of a reporting partnership⁷ between NPR, WPLN and Kaiser Health News.

1 allocating   

分配，分派( allocate的现在分词 )； 把…拨给

参考例句：

• Administrative practice generally follows the judicial model in allocating burdens of proof. 在分配举证责任方面，行政实践通常遵循司法模式。
• A cyclical multiplexing technique, allocating resources in fixed-time slices. 以固定的时间片分配资源的循环复用技术。

2 byline   

n.署名；v.署名

参考例句：

• His byline was absent as well.他的署名也不见了。
• We wish to thank the author of this article which carries no byline.我们要感谢这篇文章的那位没有署名的作者。

3 oversees   

v.监督，监视( oversee的第三人称单数 )

参考例句：

• She oversees both the research and the manufacturing departments. 她既监督研究部门又监督生产部门。 来自《简明英汉词典》
• The Department of Education oversees the federal programs dealing with education. 教育部监管处理教育的联邦程序。 来自互联网

4 discrepancies   

n.差异，不符合（之处），不一致（之处）( discrepancy的名词复数 )

参考例句：

• wide discrepancies in prices quoted for the work 这项工作的报价出入很大
• When both versions of the story were collated,major discrepancies were found. 在将这个故事的两个版本对照后，找出了主要的不符之处。 来自《简明英汉词典》

5 Founder   

n.创始者，缔造者

参考例句：

• He was extolled as the founder of their Florentine school.他被称颂为佛罗伦萨画派的鼻祖。
• According to the old tradition,Romulus was the founder of Rome.按照古老的传说，罗穆卢斯是古罗马的建国者。

6 donor   

n.捐献者；赠送人；(组织、器官等的)供体

参考例句：

• In these cases,the recipient usually takes care of the donor afterwards.在这类情况下，接受捐献者以后通常会照顾捐赠者。
• The Doctor transplanted the donor's heart to Mike's chest cavity.医生将捐赠者的心脏移植进麦克的胸腔。

7 partnership   

n.合作关系，伙伴关系

参考例句：

• The company has gone into partnership with Swiss Bank Corporation.这家公司已经和瑞士银行公司建立合作关系。
• Martin has taken him into general partnership in his company.马丁已让他成为公司的普通合伙人。