Comparing Illinois New Law & the VA when it comes to Kidney Transplants

As I was reading recent news on a few of my regular websites, someone mentioned that the State of Illinois passed a law which will provide funding for kidney transplants for illegal immigrants as well as the annual medications needed to maintain the transplanted organs.

According to the Chicago Tribune story, the law went into effect in October and transplant centers in Illinois have been evaluating some of the 686 illegal immigrants in the state’s kidney dialysis program to see whether they are healthy enough to receive kidney transplants and placing some on kidney transplant waiting lists. Of course many people, even those who agree with the law worry that illegals from out of state will try to take advantage of Illinois’ new program, which could jack up costs.

Illinois law makers are of course praising the bill’s passage, saying it’s the medically ethical thing to do, but I have to wonder, how many Veterans are waiting for organ transplants?

According to the VA’s website, the VA has offered organ transplant services since 1962 and bone marrow transplant services since 1982. As of now, there are no real numbers provided of Veterans who are either waiting to get on an organ transplant list or those who are on lists waiting for transplants.

There is a lot to consider when facing an organ transplant. Matching the medical characteristics of the candidates waiting against those of the donor includes more than just tissue match and blood type. They have to consider the length of time on the waiting list, the person’s immune status, distance between the potential recipient and the donor and the degree of medical urgency which all play a factor in whether one will receive an organ or not.

When a patient is selected, they must be available at a moment’s notice, healthy enough to undergo major surgery and willing to be transplanted immediately. Also, a lab test to measure compatibility between the donor and potential recipient may be necessary. If the organ is refused for any reason, the transplant hospital of the next patient on the list is contacted and the process continues until a match is made. Once a patient is selected and contacted and all testing is complete, transplant surgery happens.

While there are different factors depending on the organ needed for transplant, there are over 130 hospitals across the lower 48 States which perform liver transplants and approximately 300 which perform kidney transplants. However according to the VA’s website there are only 12 VA transplant centers across the States, which are divided into five regions. Only 5 of the 12 perform liver transplants, and 6 perform kidney transplants.

If there are any Veterans living in the State of Illinois who are waiting for a kidney transplant, the closest VA transplant facility which handles kidney transplants is either in Iowa City, Iowa or Pittsburg, Pennsylvania. This is compared to the 9 hospitals within Illinois which perform kidney transplants, and who will most likely perform state funded transplants for hundreds of illegals.

A study came out back in March 2014 which showed that US Veterans who need a liver transplant are less likely to get a new organ and are more likely to die the farther they live from a VA liver transplant center. Researchers looked at more than 50,000 veterans who were eligible for liver transplants who also received care between 2003 and 2010. For each added 50-100 miles distance from their local VA hospital to a VA transplant center, a veteran had a 9 percent lower chance of being put on the waiting list at a transplant center.

Among veterans with severe liver disease, 7 percent of those within 100 miles and 3 percent of those farther than 100 miles were put on a waitlist. Among those who made it to a waitlist, liver transplants were performed in 64 percent of those within 100 miles and in less than 55 percent of those farther than 100 miles.

There was an extensive study published in 2007 which compared the time to transplantation among patients insured by the VA to those insured by private insurance or Medicare/Medicaid who needed kidney transplants. The study found that both VA-insured and Medicare/Medicaid-insured patients were approximately 35% less likely to receive transplants than patients with private insurance with most difference which was explained by the fact that VA patients were less likely to be placed on the wait-list. However even listed VA patients received transplants less frequently than privately insured patients. The study concluded that VA-insured patients are less likely to receive transplants than privately insured patients, and that further studies are needed to identify the reasons for the differences. While I’ve done a search for more recent studies, I’ve yet to find one.

While the need for organ transplants is great, as with other issues, care and transplant chances among our Veterans seems to be that they are sent to the back of the line if they go through the VA. Veterans who have been waiting for a kidney transplant might want to check out Illinois and claim to be an illegal immigrant. They may receive care faster.