Strategies to Improve Liver Allocation, Distribution, and Utilization in a Broader Sharing Climate

Purpose of the Review In an attempt to eliminate geographic disparities in median MELD at transplant, the allocation of deceased donor liver allografts has transitioned to the use of acuity-based circles. This has provided new obstacles for both organ procurement organizations and transplant centers...

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Bibliographic Details
Published in:Current transplantation reports 2021-03, Vol.8 (1), p.1-8
Main Authors: Gracon, Adam D., Foley, David P.
Format: Article
Language:English
Subjects:
Immunology
Liver Transplantation (DC Mulligan and R Batra
Medicine
Medicine & Public Health
Section Editor
Surgery
Topical Collection on Liver Transplantation
Transplant Surgery
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Summary:Purpose of the Review In an attempt to eliminate geographic disparities in median MELD at transplant, the allocation of deceased donor liver allografts has transitioned to the use of acuity-based circles. This has provided new obstacles for both organ procurement organizations and transplant centers to accommodate the implications of a broader sharing climate. Recent Findings With changes to allocation, OPOs and transplant centers have experienced new challenges in donor organ evaluation and logistics. However, these changes present an opportunity to refocus on the deceased liver donation process. Opportunities exist to develop strategies to optimize collaborations between OPOs and transplant centers, facilitate informed donor organ evaluation and acceptance, and create efficiency in donation logistics. Summary By standardizing the evaluation of deceased donors and providing the necessary tools to ensure informed transplant center decisions regarding organ acceptance, improved efficiency in the new allocation system can be attained. Similarly, with anticipated changes in organ recovery travel and logistics, increasing reliance on local surgeon recovery and improved communication tools have the potential to facilitate adaptation to geographic changes in allocation and reduce costs.
ISSN:2196-3029
2196-3029
DOI:10.1007/s40472-021-00316-3