LAUSR

with organs donated within the state. The centers that perform liver transplants are in Nashville, Richmond, Madison, Portland, Pittsburgh and Houston. Unfortunately, as reported in “The AJT Report” in 2014, veterans who need a liver transplant are less likely to get one—and more likely to die—the farther they live from a VA Transplant Center.1 Dr. Knechtle says that the limited number of centers means that the VA “has tried to duck their responsibility to a degree.” Approximately 1,800 enrolled and medically eligible veterans undergo transplant evaluation every year. Physicians at the patient’s local VA perform the assessment, and the results are packaged and referred with the patient to the VA Transplant Center. The center evaluates and approves the package and places the patient on the transplant list. Unfortunately, the time to listing can be exceptionally long, says Dr. Knechtle. While, in most cases, patients on the list to receive a kidney can be stabilized, some patients requiring a liver are in urgent need of a transplant. Since it can take a long time to obtain an appointment within the VA system, some veterans die as they work their way through the lengthy evaluation process to even reach approval for listing.