Equitable allocation of extrarenal organs: with special reference to the liver

Abstract

A national plan is proposed for the equitable allocation of extrarenal organs, with particular reference to the liver. The principles of the plan include preferential use of the organs in the local and regional area of procurement, with national listing of the organs left over after the original cut. At each of the local, regional, and national levels, the allocation is based on total points awarded for medical urgency, time waiting, blood group conformity, and physical location of both donor and recipient. The plan, which should be applicable as well for allocation of hearts, is compatible with international sharing with nearby countries such as Canada.

Fig 1

UNOS regions. Note that Hawaii is in region 5.