Tennessee is one of the best places in the United States to get a liver transplant, with shorter wait times and higher rates of donation than much of the rest of the country. But new rules proposed by the nation’s largest transplant network might soon redraw the map for the way organs are distributed across the country, potentially dethroning the state from its top post. Nashville’s Vanderbilt University Medical Center is now loudly petitioning against the decision, Nashville Public Radio reports.

In August, the United Network for Organ Sharing (UNOS) announced a new proposal that would allow for a wider sharing of donated livers across the United States by redrawing the nation’s 11 transplant regions into eight larger districts. The group’s aim is to help ease the regional disparities in available livers that for years have forced many people in places like New York and California to leave home for places like Tennessee to increase their odds of receiving a lifesaving transplant. 

However, top surgeons and health workers at Vanderbilt University Medical Center, one of Tennessee’s top liver transplant centers, are not happy about the new plan. In recent public comments, they have argued that the map redesign could become a logistical headache for health care facilities like theirs, which under the new rules, could be forced to regularly fly organs hundreds of miles to reach recipients in underserved areas.

Vanderbilt is also arguing that local community outreach efforts have largely contributed to its success as a transplant center over other areas and that the new distribution system could end up providing very little incentive for Tennesseans to keep donating their organs at such a high rate.

UNOS sees its new map as more fair, arguing that the bigger problem to address right now is that patient access to liver transplants currently varies widely from state to state. The proposed change is up for public comment through mid-October, at which point an official decision will be made.

To check out the proposal online, click here.