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Letters
September 21, 1994

The Distribution of Organs for Liver Transplantation

Author Affiliations

United Network for Organ Sharing Portland, Ore

JAMA. 1994;272(11):848. doi:10.1001/jama.1994.03520110026012
Abstract

To the Editor.  —The article by Dr Bronsther and colleagues1 contained serious inaccuracies and misleading statements.The first national liver allocation protocol adopted by the United Network for Organ Sharing (UNOS) was based on a system recommended by one of the authors of the article by Bronsther et al. A preexisting, voluntary organ sharing sys tem called UNOS STAT was continued on a voluntary basis for the sickest patients. It permitted organ procurement organizations to override the national allocation system and distribute livers to UNOS STAT patients from the national pool of waiting patients before considering patients listed on local, regional, and national waiting lists who ranked higher than the UNOS STAT patients for receipt of these organs.Bronsther et al incorrectly assert that allocation tended to be autoregulatory when the UNOS STAT classification was in place. To the contrary, by October 1989 the transplant community began to question

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