Organ distribution without geographic boundaries: A possible framework for organ allocation

Area of Science:

• Transplantation Medicine
• Health Policy
• Bioethics

Background:

• Current Organ Procurement and Transplantation Network (OPTN) policies rely on geographic regions for organ allocation.
• These policies are being re-evaluated for compliance with the Final Rule, which prohibits allocation based solely on candidate residence.
• Concerns exist regarding organ wastage and transplant futility under existing regional allocation systems.

Purpose of the Study:

• To propose a new organ allocation framework that aligns with the Final Rule's mandates.
• To enhance organ distribution efficiency and promote equitable access to transplants.
• To optimize the utilization of scarce donor organs.

Main Methods:

• Developing a borderless allocation score system.
• Integrating existing medical priority scores (e.g., MELD, LAS) with novel geographic feasibility scores.
• Geographic feasibility scores will consider organ ischemia time, donor-recipient travel logistics, and organ shipping costs.

Main Results:

• The proposed borderless system aims to overcome limitations of current regional allocation policies.
• It seeks to balance medical urgency with logistical considerations for organ placement.
• This approach is designed to fulfill Final Rule requirements for organ distribution.

Conclusions:

• A borderless organ allocation system offers a viable solution to meet Final Rule mandates.
• This model promotes equity, utility, and efficiency in organ transplantation.
• It ensures optimal use of a scarce resource by minimizing geographic barriers.