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A Critique of UNOS Liver Allocation Policy

Published online by Cambridge University Press:  01 July 1999

KENNETH EINAR HIMMA
KENNETH EINAR HIMMA
Affiliation:
University of Washington School of Law and University of Washington
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Abstract

The United Network for Organ Sharing (UNOS) recently changed the policy by which donor livers are allocated to liver failure patients in the United States. Formerly, all liver failure patients were characterized as status 1 and placed at the top of the transplant list. Under the new policy, only patients with liver failure due to acute illness (“ALF patients”) are eligible for status 1; patients with liver failure due to chronic liver disease (“CLF patients”) are characterized as status 2. Since donor organs are allocated first to status 1 patients and then to status 2 patients, the new policy moves all CLF patients down on the waiting list relative to all ALF patients. This means that some livers that would have gone to CLF patients under the old policy will now go to ALF patients. Accordingly, while the new policy will likely increase the number of ALF patients saved, it will also increase the number of deaths among CLF patients waiting for a transplant.

Type
SPECIAL SECTION: Organ Transplantation: Shaping Policy and Keeping Public Trust
Information
Cambridge Quarterly of Healthcare Ethics , Volume 8 , Issue 3 , July 1999 , pp. 311 - 320
Copyright
© 1999 Cambridge University Press

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