Liver allocation.

Liver allocation. Minerva Gastroenterol Dietol. 2017 Nov 10;: Authors: Neuberger J Abstract Liver allocation policies determine how those livers that are offered for transplantation are allocated to those who have met the criteria for liver transplantation and are fit enough to undergo the procedure. The goals of allocation policies are based on varying combinations of need (reducing mortality awaiting a graft), benefit (maximising the outcomes of candidates on the list) or utility (maximising the life-years gained). Improvement in quality of life is rarely included in the setting of allocation policies. Policies need to be complaint with legal and ethical standards, ensure equity, and provide transparency. Most jurisdictions have used two major categories: high-urgency (such as acute liver failure) and elective where candidates are ranked according to need. Need for these candidates is often measured by the MELD score (or its modifications): although there are many valid concerns about the model, it remains the most widely used. Some jurisdictions are developing models which allocate on the basis of transplant benefit. It is important that allocation models do not stifle innovation and research. Different jurisdictions have developed different approaches to respond to the variations in both donors and recipients, the geographical challenges, prevalence of liver disease and donor rates and how to include those whose prognosis is not ...
Source: Minerva Gastroenterologica e Dietologica - Category: Gastroenterology Tags: Minerva Gastroenterol Dietol Source Type: research