How Should Deceased Donor Organs Be Allocated? The Patient's Perspective Derived from Semi-Structured Interviews

Area of Science:

• Medical Ethics
• Transplantation Medicine
• Public Health Policy

Background:

• Growing global disparity between deceased donor organ supply and demand.
• Increasing mortality rates for patients awaiting organ transplantation.
• Need for ethical frameworks in organ allocation to address patient needs.

Purpose of the Study:

• To explore the unique perspective of organ transplant recipients on donor organ allocation rules.
• To understand patient preferences regarding criteria for organ distribution.
• To inform ethical discussions on organ allocation policy.

Main Methods:

• Semi-structured telephone interviews with 12 patients and relatives of organ transplant recipients in Germany.
• Inclusion of patients who received lung, heart, kidney, and liver transplants.
• Analysis of interview transcripts using the deductive framework method, adhering to COREQ guidelines.

Main Results:

• Patients emphasize medical urgency and transplantation effectiveness as key allocation factors.
• Consideration of recipient responsibility for organ failure and appreciation for the donated organ.
• Preference for allocation rules maximizing both life years and quality of life gained.

Conclusions:

• Patient perspectives offer unique insights into organ allocation, highlighting consensus on some rules but difficulty with precise cutoffs.
• Patient representatives' involvement is crucial in the ongoing debate and development of donor organ allocation policies.
• Integrating patient values into allocation frameworks can lead to more equitable and effective organ distribution.