Outcome of a Change in Allocation of Livers for Transplant in the United States
Kyle H. Sheetz, Seth A. Waits
Abstract
On February 4, 2020, the Organ Procurement and Transplant Network and United Network for Organ Sharing (UNOS) implemented a new policy for allocating donor livers for transplant. The policy moves away from a donor service area-based allocation model and instead focuses on radially oriented zones (acuity circles) around potential donors. Its goals are to improve access to transplant for the candidates with the greatest urgency, increase the number of pediatric transplants, and reduce waitlist mortality. 1 However, there are also concerns that it may reduce access for socioeconomically disadvantaged groups (eg, patients in rural areas) and significantly increase travel burden for liver recovery. [2] 3][4] Using data from UNOS, we assessed whether implementation of the policy was associated with immediate changes in the distance traveled for recovery or the proportion of organ imports or exports by UNOS regions.