Critics say new transplant rules will benefit big city medical centers

The organization that controls the distribution of livers for transplant revised its controversial allocation policy for the second time in a year, further limiting transplant centers’ access to organs collected in their areas.

The new plan eliminates geographical boundaries drawn years ago that had largely given transplant centers first shot at livers collected from brain-dead donors in hospitals nearby. It moves the liver transplant system farther toward a “sickest-first” model that would send organs to recipients more than 500 miles away if they demonstrate the greatest need.

Critics said the new plan will inevitably transfer livers from rural and low-income parts of the South, Midwest and Northwest to big city transplant centers in New York, Boston, Houston, Minneapolis and other locations where populations are larger and demand is relentless.