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Regulatory and Fiscal Relationships between Transplant Centers and Transplant Surgeons/Physicians

Michael M. Abecassis

Dixon B. Kaufman

Organ transplant centers are complex expensive enterprises that are highly regulated by federal and state government. The Code of Federal Regulation describes minimum requirements for transplant centers, the process for certification as a transplant center, obligations and responsibilities of transplant centers, acceptable accounting practices for costs of organ acquisition, and the rules for allocation of scarce transplantable organs into potential recipients on lengthy waiting lists. Transplant centers must appoint a medical director for each transplanted organ. Although a hospital "owns" the transplant center and is responsible for all fiscal matters, it is the medical director who plans, organizes, and leads the extensive staff in execution of the transplant center's activities. Functional integrity of the transplant center is best protected when transplant surgeons and physicians, as well as the hospital administrative officers, understand the regulatory and fiscal relationships established by law.

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