About 60,000 people in the United States are waiting for new organs

In this story:

• Geography vs. medical need
• Amid debate, thousands are still waiting
• Who should get priority?
• Related stories and sites

WASHINGTON (CNN) -- A new federally ordered organ donor system to distribute organs to the sickest patients nationwide rather than regionally was scheduled to go into effect Thursday, but legal wranglings have kept it locked in court.

On Wednesday, a federal judge blocked the new system from taking effect until an October 14 hearing on a lawsuit brought by Louisiana.

Earlier this year, Louisiana passed a law requiring all organs donated in the state to be used in the state if possible. The new federal rule would have taken precedence over the state law.

The current allocation system divides the country into 65 locally controlled regions. When an organ becomes available in a region, the patient in that region with the greatest need gets the first opportunity to receive the organ.

Geography vs. medical need

In March, Health and Human Services Secretary Donna Shalala proposed restructuring the system to a national allocation program that puts patients with the greatest need anywhere in the country at the top of the list.

"Non-medical criteria, such as geography, should not drive allocation decisions," she said. "We want allocation decisions to be based on medical criteria."

Although HHS estimates a national system will increase organ donation by 20 percent, critics argue that fewer people will donate organs if they won't necessarily be used by people in their community.

Amid debate, thousands are still waiting

Around 60,000 people in the United States need a new heart, liver, kidney or other organ. At least 10 a day die while on the waiting list.

Proposed federal changes in the system could make some patients wait even longer

Guy Hodge, 53, of Philadelphia has been waiting at Virginia's Inova Fairfax Hospital, which specializes in transplants. If a new liver becomes available and it's compatible, he's next.

"I'm waiting for a liver and I've been waiting since last August when doctors told me I had only three months to a year to live if I did not get a new organ," he said.

The proposed changes could make his wait even longer because someone elsewhere in the country, who is even sicker, could get the next liver that becomes available in Hodge's part of the country.

Who should get priority?

Some doctors, such as Hodge's, believe the new system will provide organs for many who are too sick to handle the procedure and deprive those who are a little less sick, but who are strong enough to handle the surgery.

"If you transplant only the sickest individuals, more of those patients require re-transplantation because the liver doesn't always work right away," said Dr. Timothy Shaver, director of abdominal transplantation at Inova Fairfax Hospital. "Then you do fewer total patients, not fewer total transplants."

Defenders of the proposal say the truly sick should not lose out to the less sick because of where they live.

"Transplantation was designed to save the patients who have the least time to live," said Dr. John Fung, chief of transplant surgery at the University of Pittsburgh Medical Center. "It was a last hope and we're not doing that.

"There are patients who are being transplanted when they could have had another therapy done," he said.

Reporter Louise Schiavone contributed to this report.