听力来源：NPR，仅用于个人英语学习。
小建议：请到NPR官网-本音频页面聆听或下载本音频。先花10分钟听两遍音频，再看文本，效果更佳。
内容简介：本文是讨论美国器官移植系统分配新规，捐献的肝脏由就近分配改为根据病情危重优先，因此，器官捐献率高的州（南部和中西部）对新规有异议。为了便于理解文章，我在网上找了美国各州地图，附在文章开头。
向器官捐献者致敬，他们生命的礼物，带来了爱的奇迹(miracle)。
As Thousands Wait For Transplants, Medical Centers Fight To Keep Livers Close To Home
May 14, 2019
美国各州中英文对照-图片来自网络
AUDIE CORNISH, HOST:A new system for allocating donated livers to sick patients went into effect this morning. The intent is to make organ transplants more fair nationwide, but transplant centers in the South and Midwest are fighting it. Blake Farmer of member station WPLN in Nashville explains why.
BLAKE FARMER, BYLINE: Karen Wells wheeled her husband into the ER at Vanderbilt University Medical Center last year, praying for a miracle. He was so jaundiced he was almost unrecognizable.
KAREN WELLS: He was dark - very dark. I mean, there was no whites to his eyes. They were orange.
FARMER: The doctors said it was time to make funeral arrangements. His body was rejecting his first liver transplant.
K. WELLS: It's a miracle, honestly, to get two...
FARMER: Two livers for one patient. It was a long shot, but fortunately, Wells lived in Tennessee, where the waiting list was shorter than on the East and West coasts. For decades, livers were donated to patients nearby, no more than a state or two away. But under the new rule, a liver must be matched with the most critical patient within 500 miles. That means a liver donated in Nashville could end up in Chicago. Brian Shepard leads the agency that oversees organ sharing. He says the new rules should save lives.
BRIAN SHEPARD: Targeting the livers towards those folks who are really the most critically ill will result in fewer people dying on the waiting list.
FARMER: But that seems unfair to transplant centers in the South and Midwest, where organ donation rates are higher. More people there sign up to donate, and they also die more often in ways that allow their organs to be used, like from a stroke. The old regional discrepancies meant some patients could game the system. When he needed a liver, Apple founder Steve Jobs even bought a house in Memphis.
SANDY FLORMAN: He didn't do anything illegal, but he took advantage of a system because he was able to, financially.
FARMER: Sandy Florman is transplant director at Mount Sinai Hospital in New York City, with one of the longest waiting lists in the country.
FLORMAN: The problem is it's turned into a turf battle. These are very profitable hospitals, and people are afraid that their programs will not do well.
FARMER: A dozen transplant centers sued to stop the policy from taking effect, including Emory, University of Michigan and Vanderbilt. But all they got was a few extra weeks. Seth Karp is Vanderbilt's transplant director. He predicts unexpected delays because many more hospitals will now have to weigh in when a liver becomes available.
SETH KARP: The more complex the distribution scheme is, the more chances you have of not using the liver.
FARMER: Karp estimates Vanderbilt will perform 20% fewer transplants and may have to downsize. And he worries about smaller centers.
KARP: The - if the program in Mississippi closes, if the program in Iowa closes because of this, that's a real national public health problem.
FARMER: I asked Jeffrey Wells, the patient who was near death at Vanderbilt last year, what he thought. He did get that second liver transplant, benefiting from the shorter waiting list.
JEFFREY WELLS: And I'm eternally grateful.
FARMER: Wells actually supports the new rule.
J. WELLS: I mean, I'm like this. When a person decides to be a donor, I don't feel like they're becoming a donor to save one particular person's life.
FARMER: But the transplant centers that sued say they'll keep up their fight in the courts. For NPR News, I'm Blake Farmer in Nashville.
CORNISH: And this story is part of a reporting partnership between NPR, WPLN and Kaiser Health News.
知识点笔记：
1.文中与器官捐献和移植有关的表达：
- organ transplant:器官移植,包括liver transplant（肝脏移植，文中举例），kidney transplant(肾脏移植)，heart transplant（心脏移植），等等。
- donor捐献者；sign up to donate登记（意愿）成为捐献者；organ donation rate are high/low器官捐献率高/低
- the system for allocating donated organs器官分配系统
- reject （器官移植）排异
- on the waiting list排队等待；short/long waiting list指排队等待时间短/长
2....wheeled her husband into the ER,
ER: emergence room急诊室 wheel就是推着（有轮子的）物体走，比如自行车。在医院里，就是指推着担架车。
e.g. She's just about to be wheeled into surgery.
3.a long shot: used to say that a plan is worth trying, even though you think it is unlikely to succeed 值得一试，但不太可能成功的
e.g.1. It's a long shot, but someone might recognise her from the photo and be able to tell us where she lives.
2.The deal was a long shot, but Bagley had little to lose...
3.I thought about meeting a handsome stranger but it seemed a bit of a long shot.
4....end up in Chicago
回忆end up doing（出乎意料的）结果，这里也有这个意思
5.oversee负责；监管
e.g.1.Use a surveyor or architect to oversee and inspect the different stages of the work.
2....the agreement to set up a commission to oversee the peace process.
6.这两个短语都是指钻系统/法律的空子，谋求自己的利益。
- game the system：to use rules or laws to get what you want in an unfair but legal way
- take advantage of the system: 回忆复习在前面关于关税的文章中学到了take advantage of占便宜
7.turf草皮，引申为地盘
e.g.1.Their turf was Paris: its streets, theaters, homes, and parks...
2.American multinationals make 12% on their home turf.
a turf battle/war就是“地盘”之争了
e.g. Turf wars are inevitable when two departments are merged.
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