Organ Allocation

2021 ◽  
Author(s):  
Carli J. Lehr ◽  
Maryam Valapour
Keyword(s):  
Organ Allocation

Diminished autonomy and justice in liver transplantation – The price of scarcity?

2021 ◽  
pp. 147775092110162
Author(s):  
Philip Berry ◽  
Sreelakshmi Kotha
Keyword(s):  
Patient Autonomy ◽  
Patient Involvement ◽  
Organ Allocation ◽  
Self Determination ◽  
Wait List ◽  
Medical Assessment ◽  
Patient Factors ◽  
Future Directions ◽  
Allocation Criteria ◽  
Qualitative Nature

Patient autonomy and distributive justice are fundamental ethical principles that may be at risk in liver transplant units where decisions are dictated by the need to maximise the utility of scarce donor organs. The processes of patient selection, organ allocation and prioritisation on the wait list have evolved in a constrained environment, leading to high levels of complexity and low transparency. Regarding paternalism, opaque listing and allocation criteria, patient factors such as passivity, guilt, chronic illness and sub-clinical encephalopathy are cited as factors that may inhibit patient engagement. Regarding justice, established regional, gender and race based inequities are described. The paradox whereby hepatologists both advocate for individual patients and discharge their duty of stewardship to apportion organs according to larger utilitarian principles is explored. Competing subjective factors such as physicians’ perception of moral responsibility, the qualitative nature of expert medical assessment and institutional or personal loyalty to re-transplantation candidates are described. Realistic limits of self-determination and justice are discussed, and possible future directions in terms of patient involvement proposed.

Identification of an Arabidopsis solute carrier critical for intracellular transport and inter-organ allocation of molybdate

Plant Biology ◽  
2011 ◽  
Vol 13 (5) ◽  
pp. 710-718 ◽  
Author(s):  
A. Gasber ◽  
S. Klaumann ◽  
O. Trentmann ◽  
A. Trampczynska ◽  
S. Clemens ◽  
...  
Keyword(s):  
Intracellular Transport ◽  
Organ Allocation ◽  
Solute Carrier

Sarco‐Model: A score to predict the dropout risk in the perspective of organ allocation in patients awaiting liver transplantation

2021 ◽  
Author(s):  
Quirino Lai ◽  
Paolo Magistri ◽  
Raffaella Lionetti ◽  
Alfonso W. Avolio ◽  
Ilaria Lenci ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Organ Allocation

Organ allocation and procurement in cardiac transplantation

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Peter J. Altshuler ◽  
Mark R. Helmers ◽  
Pavan Atluri
Keyword(s):  
Cardiac Transplantation ◽  
Organ Allocation

A Rational Reconstruction of Expert Judgments in Organ Allocation

2001 ◽  
Vol 23 (2) ◽  
Author(s):  
Adele Diederich
Keyword(s):  
Waiting Time ◽  
German Law ◽  
Organ Allocation ◽  
International Exchange ◽  
Simulation Studies ◽  
Allocation System ◽  
Kidney Allocation System ◽  
Time Distance ◽  
Computer Simulation Studies ◽  
High Degree

AbstractThe Eurotransplant Kidney Allocation System (ETKAS) emerged from the XCOMB model by Wujciak and Opelz (1993a,b), who applied computer simulation studies to create an allocation algorithm. The present study investigated how experts would allocate a donated organ to patients on the waiting list with respect to the five allocation factors proposed in the ETKAS (number of mismatches, mismatch probability, waiting time, distance, international exchange balance). The experts’ evaluations were compared to the ETKAS points as well as to factor weights established in mandatory allocation guidelines which are based on the German law for organ allocation (Transplantationsgesetz). The investigation was carried out using a conjoint analysis. Overall, the results indicate a fairly high degree of agreement between the experts’ opinions and the existing allocation system ETKAS and even more so for the allocation guidelines, in particular, with respect to the factors Mismatches, Mismatch probability, and Waiting time.

Rationing scarce organs for transplantation: healthcare provider perspectives on wait-listing and organ allocation

2012 ◽  
Vol 27 (1) ◽  
pp. 60-71 ◽  
Author(s):  
Allison Tong ◽  
Stephen Jan ◽  
Germaine Wong ◽  
Jonathan C. Craig ◽  
Michelle Irving ◽  
...  
Keyword(s):  
Healthcare Provider ◽  
Organ Allocation ◽  
Provider Perspectives ◽  
Healthcare Provider Perspectives

Effects of the 2006 U.S. thoracic organ allocation change: Analysis of local impact on organ procurement and heart transplantation

2010 ◽  
Vol 29 (3) ◽  
pp. 235-239 ◽  
Author(s):  
Jose N. Nativi ◽  
Abdallah G. Kfoury ◽  
Craig Myrick ◽  
Melissa Peters ◽  
Dale Renlund ◽  
...  
Keyword(s):  
Heart Transplantation ◽  
Organ Procurement ◽  
Organ Allocation ◽  
Change Analysis ◽  
Local Impact ◽  
Thoracic Organ
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