Life - and Livers 

Two meetings of the Shelby County Commission — this week and last — were of the sort which suggest that, politics-as-usual notwithstanding, our local governments may, after all, be capable of separating the wheat from the chaff on matters requiring decisive action and sophisticated judgment.

The central issue in both meetings — a convening of the commission's health and hospitals committee last Wednesday and its regular biweekly session on Monday — was whether the commission should intervene in a matter that was, strictly speaking, beyond its jurisdiction and, if it did intervene, to what end.

The issue was that of a new federal policy which, at the end of the current calendar, would shrink the local supply area from which livers can reliably be obtained to perform transplant surgery in Memphis. Up to this point, the UT-Methodist Transplant Institute, a world-class facility overseen by Dr. James Eason, has been able to secure such available organs from the whole of Tennessee and from an area somewhat beyond. Eason's group is the fourth-largest performer of liver transplants in the country and earned extra recognition as of 2009, when Eason performed a liver transplant on the legendary Steve Jobs — one that arguably kept the cancer-ridden Apple entrepreneur alive long enough to introduce the revolutionary iPad.

But there's a rub there, too. Though the Flyer's John Branston investigated the matter thoroughly and established that Jobs earned his place on the local organ list fair and square (mainly because he had diligently made application in numerous places simultaneously), the prominence of the patient was such as to invite speculation and envy elsewhere. Bluntly put, other hospitals weren't necessarily thrilled to see the local unit do so well, especially those, like Vanderbilt University Medical Center in Nashville, which had its own elite transplant programs.

Whether the Jobs matter had anything to do with it or not, the United Network for Organ Sharing, which is the liaison organization for such matters with the federal government, was moved to expedite rule changes already underway that would restrict the organ supply network for UT-Methodist Transplant Institute to the Mid-South Transplant Institute, a well-regarded local organization serving the Mid-South area but, in a primary sense, only the Mid-South area, where last year some 61 livers were made available. In a typical year, UT-Methodist performs 150 liver transplants. Accordingly, Eason's unit is lobbying hard for Mid-South Transplant to merge with Tennessee Donor Services (TDS), a far larger organization covering the rest of Tennessee or, failing that, for Medicare-Medicaid Services to grant the hospital a waiver so as to be able to transact with TDS on a primary basis.

Otherwise, warned Eason, patients here will endure longer waits for available organs, and, he said, bluntly, "people will die."

On a motion by Commissioner Steve Mulroy, the commission endorsed the UT-Methodist position without a dissenting vote, treating it as what it may well be: a life-and-death matter. Commissioner Mike Ritz further urged the administration of County mayor Mark Luttrell to lobby the federal government on behalf of the local unit. Well done by all.




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