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Rescuing Prometheus: a policy proposal to alleviate excess demand for liver transplantation
1Ohio State University Medical Center, Division of Transplantation, Columbus 43210, USA.
Clinical Transplantation
|February 1, 1997
Summary
The demand for liver transplants exceeds the available organ supply, creating a critical shortage. Managing demand could reduce patient waitlists and healthcare costs.
Area of Science:
- Hepatology
- Transplantation Medicine
- Health Policy
Background:
- Increasing demand for liver transplantation contrasts with a limited supply of donor organs.
- This disparity creates an excess demand crisis, leaving many patients on waiting lists.
- The scarcity of livers presents a unique rationing dilemma within the US medical community.
Purpose of the Study:
- To analyze the excess demand crisis in liver transplantation.
- To explore the implications of organ scarcity on allocation and patient listing criteria.
- To propose a cohesive rationing policy addressing both organ supply and demand.
Main Methods:
- Quantifying excess demand by analyzing patients on the UNOS waiting list.
- Examining policy debates surrounding organ allocation and patient selection.
- Evaluating demand-side management strategies for liver transplantation.
Main Results:
- Excess demand is defined as patients on the UNOS waiting list not transplanted, expired, or withdrawn.
- Organ scarcity necessitates confronting a true rationing dilemma in liver transplantation.
- Debates on allocation and patient listing criteria are intensified by the excess demand crisis.
Conclusions:
- A comprehensive rationing policy must manage both organ supply and demand.
- Demand-side management can potentially reduce critically ill patients awaiting transplants.
- Implementing demand-side strategies may decrease retransplants and overall transplantation costs.