Modern technology has made it possible to transplant many failed organs. We now transplant kidneys, livers, lungs, and even hearts. In 2022, more than 42,800 organ transplants were performed in the U.S., according to the United Network for Organ Sharing (UNOS). This is a record, an increase of 3.7 percent over the previous record in 2021.

Also, for the first year ever, more than 25,000 kidney transplants were performed in the United States. The total of 25,498 marked an increase of 3.4 percent over 2021. In addition, annual records were set for liver (9,528), heart (4,111) and lung (2,692) transplants.

“In a year that we commemorated one million transplants performed nationwide, we are glad to mark accelerated progress toward the next million,” said Jerry McCauley, M.D., M.P.H., president of the UNOS Board of Directors. ”We thank all the living and deceased organ donors, as well as the loved ones of deceased donors, who have provided a lifesaving gift. We also honor all the clinicians and professionals involved in organ donation and transplantation, who work tirelessly to make as many transplants happen as possible every day. We also should rededicate ourselves to meeting the continuing need,” added Dr. McCauley. “Many people still wait anxiously for a life-giving transplant. We must continue to improve in our capabilities to give them this vital opportunity by ensuring use of as many donated organs as possible.”

With all this progress in making organ transplants available to more and more Americans, you would think we would be doing everything possible to make these transplants a long-term success. Alas, this is not the case.

The Wall Street Journal editorial board says, “Government spending on healthcare often leads to rationed care owing to rising costs. Think of the waiting lists in Canada and new price controls on U.S. drugs. Another mistake is playing out in care for organ-transplant patients denied coverage for blood tests that detect problems.”

In March, MolDX, a program run by Medicare contractor Palmetto GBA to make coverage decisions on molecular lab tests, changed its guidance for when certain blood tests can be used. The tests, which use molecular technology to catch signs of organ rejection, are often ordered for patients who had kidney, heart or lung transplants. Under the contractor’s new policy, the tests can no longer be used as part of routine monitoring care for most patients.

The tests are expensive. Blood tests for kidney and heart rejection can cost $2,800-$3,200 each. To be most useful, they have been administered regularly to help doctors monitor the body’s response to a new organ. The tests pick up how failing organs shed donor DNA into the bloodstream, catching problems early. By the time a patient shows up with a fever, organ rejection is often advanced.

Stanford pediatric nephrologist Ken Sutha told WSJ that doctors must often walk a tightrope with transplant patients. The patients take immuno-suppressant drugs to prevent organ rejection. But if they get sick, their doctors must back off the suppressants to let their bodies fight the illness.

Blood tests are critical during that time for monitoring early signs of organ rejection. Dr. Sutha knows this as a practitioner and patient. He received a kidney donation from his father when he was 24, but lost it when the rejection wasn’t controlled. The alternative to the blood tests is an invasive biopsy that is also expensive and may be done too late to save the organ. Palmetto’s MolDX program answers to the federal Centers for Medicare and Medicaid Services (CMS).

This is a classic example of how government-controlled healthcare sacrifices the health of its beneficiaries in favor of saving government money. It is essentially rationing of care by another name. Unless you are wealthy, you cannot afford the tests so your life expectancy is jeopardized.

The American Society of Transplant Surgeons, the International Society for Heart and Lung Transplantation and the American Society of Transplantation have written letters to the contractor explaining the need for the tests. The surgeons’ group notes the change makes no sense when CMS itself has “clearly acknowledged that transplantation is the best, and most cost-effective, treatment option.”

A bipartisan letter from 12 members of Congress, including Rep. Michael Burgess(R., Texas) and Rep. Anna Eshoo (D., Calif.), to CMS administrator Chiquita Brooks-LaSure has asked for coverage to be restored. They note that MolDX’s policy may especially harm poor communities that have “less access to specialized transplant centers, making non-invasive diagnostic tests even more critical for their ongoing post transplant care.”

Remember those famous words of terror: “I’m from the government and I’m here to help!”