[Skip to Content]
Access to paid content on this site is currently suspended due to excessive activity being detected from your IP address 35.171.183.163. Please contact the publisher to request reinstatement.
[Skip to Content Landing]
Views 430
Citations 0
Viewpoint
September 2018

Allocation of Donor Livers for Transplantation: A Contemporary Struggle

Author Affiliations
  • 1Department of Surgery, University of North Carolina School of Medicine, Chapel Hill
  • 2Department of Surgery, Medical University of South Carolina, Charleston
  • 3Department of Surgery, Vanderbilt University, Nashville, Tennessee
JAMA Surg. 2018;153(9):787-788. doi:10.1001/jamasurg.2018.1519

A crucial and unique responsibility in the management of the US transplant system involves apportioning scarce and lifesaving resources. No other area of medicine has such an acute and conspicuous need than the wait for a lifesaving organ by a patient with end-stage disease. Recognizing this challenge, the US Congress passed the National Organ Transplant Act (NOTA) in 1984, which established the Organ Procurement and Transplantation Network (OPTN) and tasked it to create a framework to ensure the optimal and fair management of transplant services. The OPTN divided the United States into 58 local areas within 11 larger regions. As the transplant field matured, the US Department of Health and Human Services published the Final Rule that interprets the OPTN statute and clarifies its intent. Together, NOTA and the Final Rule specify the OPTN’s responsibilities: establishing patient-specific priority for the equitable allocation of organs on the basis of medical judgment; increasing the organ supply; and increasing transplants for children, members of racial or ethnic minorities, and individuals with limited access to transportation.1

Limit 200 characters
Limit 25 characters
Conflicts of Interest Disclosure

Identify all potential conflicts of interest that might be relevant to your comment.

Conflicts of interest comprise financial interests, activities, and relationships within the past 3 years including but not limited to employment, affiliation, grants or funding, consultancies, honoraria or payment, speaker's bureaus, stock ownership or options, expert testimony, royalties, donation of medical equipment, or patents planned, pending, or issued.

Err on the side of full disclosure.

If you have no conflicts of interest, check "No potential conflicts of interest" in the box below. The information will be posted with your response.

Not all submitted comments are published. Please see our commenting policy for details.

Limit 140 characters
Limit 3600 characters or approximately 600 words
    ×