The evolution of organ allocation for liver transplantation: Tackling geographic disparity through broader sharing

David A. Axelrod, Parsia A. Vagefi, John P. Roberts

Research output: Contribution to journalReview articlepeer-review

26 Scopus citations

Abstract

The liver transplant allocation system has evolved to a ranking system of "sickest-first" system based on objective criteria. Yet, organs continue to be distributed first within OPOs and regions that are largely based on historical practice patterns related to kidney transplantation and were never designed to minimize waitlist death or equalize opportunity for liver transplant. The current proposal is a move to enhance survival though the application of modern mathematical techniques to optimize liver distribution. Like MELDbased allocation, it will never be perfect and should be continually evaluated and revised. However, the disparity in access, which favors those residing in or able to travel to privileged areas, to the detriment of the patients dying on the list in underserved areas, is simply not defensible in 2015.

Original languageEnglish (US)
Pages (from-to)224-227
Number of pages4
JournalAnnals of surgery
Volume262
Issue number2
DOIs
StatePublished - Aug 30 2015

ASJC Scopus subject areas

  • Surgery

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