美国国家公共电台 NPR Searching For A Fairer Way To Distribute Donor Livers

 

DAVID GREENE, HOST:

The nation's organ transplant network is proposing a change in how livers are made available. The idea is to make the system more equitable¹, but some are worried that this change would make things less fair for some people, and we have more now from NPR health correspondent Rob Stein.

ROB STEIN, BYLINE²: Himanshu Patel is 39 and lives in Waycross, Ga. He ran a convenience store until his liver started failing.

HIMANSHU PATEL: And when I went in the hospital, they told me that you will need a liver transplant. Without the liver transplant, you might not survive.

STEIN: So Patel is anxiously waiting for a phone call to find out if his doctors found a liver for him. So is Piper Su. She's also 39 but lives about 700 miles north, in Alexandria, Va. She's still working as a lawyer, but it's getting harder.

PIPER SU: I tend to get very tired. Oftentimes, I'll have sharp pains in my abdomen³ from, you know, sort of my - my liver voicing its displeasure. And then, you know, I've developed a condition in my legs, which sometimes they retain fluid, which can be very painful.

STEIN: Patel and Su are among more than 16,000 Americans waiting for a liver transplant, but only about 7,000 livers are donated each year. So their odds⁴ aren't great. And Julie Heimbach of the Mayo Clinic says their chances depend a lot on where they live.

JULIE HEIMBACH: Some areas of the country, patients have to wait a lot longer than in other areas. They have to get much sicker before they can access liver transplant, depending on where they live.

STEIN: The reason is complicated. Part of it is that more organs become available for transplants in some places than others for lots of reasons. There are more car accidents, more deaths from strokes.

HEIMBACH: The heroin⁵ epidemic⁶ has actually led to a lot of organ donors⁸ because people become - you know, overdose. They stop breathing. They become brain-dead. And certain areas of the country have more or less of that particular problem.

STEIN: So Heimbach helped come up with a new way to distribute livers. Right now the sickest patient on the waiting list in each of 11 regions gets the next liver that becomes available in that region. The new system would basically expand access to livers to patients within 150 nautical⁹ miles from wherever the liver is donated.

HEIMBACH: And whether they're in or out of the region, as long as they're in that 150-mile circle they would be able to access that donor⁷.

STEIN: But the plan is raising a lot of concerns.

RAYMOND LYNCH: This is life-and-death stuff for real people.

STEIN: Raymond Lynch is a transplant surgeon at Emory University in Atlanta.

LYNCH: It's important to know that when you export a liver, you import a death. So if you move an organ from one place to another, you've left a hole in that original place, and that hole is going to turn into a death because now somebody in that original place doesn't have an organ transplant.

STEIN: And Lynch argues that the new plan would tend to shift too many livers from less affluent¹⁰, rural areas to richer, urban areas.

LYNCH: We would be hurting those people who are most vulnerable in the U.S. - minorities, people with reduced income, people with reduced access to primary care physicians, people who live in rural locations. All those people already do worse.

STEIN: Julie Heimbach, who came up with the new system, disputes the argument that it would cost lives and take organs away from people who need them most.

HEIMBACH: It would not be less fair. It would be more fair. It's not one-way sharing where the livers are being taken to one particular part of the country. It's a broader sharing.

STEIN: When you ask the patients what they think about all this, predictably, their perspective depends on where they live. Piper Su, who lives in Alexandria, Va., where livers are scarce, has been traveling around the country to get listed in as many places as she can.

SU: It's been a bit of an odyssey¹¹, and I think the best move for everyone involved is to try to move towards, you know, the most fair system possible that gets organs to the people who need them the most quickly.

STEIN: But Himanshu Patel, who lives in Waycross, Ga., where livers are more available, is worried about having to wait longer.

PATEL: They tell me that I have to wait another six months or something like that then that might put me in the worries that, like, I don't know if I'm going to make it for six months or not.

STEIN: The public has until October 2nd to tell the United Network for Organ Sharing what it thinks about this proposal. Rob Stein, NPR News.

1 equitable   

adj.公平的；公正的

参考例句：

• This is an equitable solution to the dispute. 这是对该项争议的公正解决。
• Paying a person what he has earned is equitable. 酬其应得,乃公平之事。

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 abdomen   

n.腹，下腹(胸部到腿部的部分)

参考例句：

• How to know to there is ascarid inside abdomen?怎样知道肚子里面有蛔虫？
• He was anxious about an off-and-on pain the abdomen.他因时隐时现的腹痛而焦虑。

4 odds   

n.让步，机率，可能性，比率；胜败优劣之别

参考例句：

• The odds are 5 to 1 that she will win.她获胜的机会是五比一。
• Do you know the odds of winning the lottery once?你知道赢得一次彩票的几率多大吗？

5 heroin   

n.海洛因

参考例句：

• Customs have made their biggest ever seizure of heroin.海关查获了有史以来最大的一批海洛因。
• Heroin has been smuggled out by sea.海洛因已从海上偷运出境。

6 epidemic   

n.流行病；盛行；adj.流行性的，流传极广的

参考例句：

• That kind of epidemic disease has long been stamped out.那种传染病早已绝迹。
• The authorities tried to localise the epidemic.当局试图把流行病限制在局部范围。

7 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。

8 donors   

n.捐赠者( donor的名词复数 )；献血者；捐血者；器官捐献者

参考例句：

• Please email us to be removed from our active list of blood donors. 假如你想把自己的名字从献血联系人名单中删去，请给我们发电子邮件。
• About half this amount comes from individual donors and bequests. 这笔钱大约有一半来自个人捐赠及遗赠。 来自《简明英汉词典》

9 nautical   

adj.海上的，航海的，船员的

参考例句：

• A nautical mile is 1,852 meters.一海里等于1852米。
• It is 206 nautical miles from our present location.距离我们现在的位置有206海里。

10 affluent   

adj.富裕的，富有的，丰富的，富饶的

参考例句：

• He hails from an affluent background.他出身于一个富有的家庭。
• His parents were very affluent.他的父母很富裕。

11 odyssey   

n.长途冒险旅行；一连串的冒险

参考例句：

• The march to Travnik was the final stretch of a 16-hour odyssey.去特拉夫尼克的这段路是长达16小时艰险旅行的最后一程。
• His odyssey of passion, friendship,love,and revenge was now finished.他的热情、友谊、爱情和复仇的漫长历程，到此结束了。