RT Journal Article
SR Electronic
T1 Selection of Patients for liver transplantation and alocation of donated livers in the UK
JF Gut
JO Gut
FD BMJ Publishing Group Ltd and British Society of Gastroenterology
DO 10.1136/gut.2007.131730
A1 James M Neuberger
A1 Alex Gimson
A1 Mervyn Davies
A1 Murat Akyol
A1 John O'Grady
A1 Andrew K Burroughs
A1 Mark Hudson
YR 2007
UL http://gut.bmj.com/content/early/2007/09/25/gut.2007.131730.abstract
AB The increasing shortfall between the number of patients who would benefit from liver transplantation and the availability of donor livers means that rationing has to occur. The processes of selection of patients for transplantation and for allocation of donor livers should be done according to ethical and, where possible, evidence-based criteria so that there is clarity and that the competing requirements of equity, justice, utility and benefit can be balanced. To achieve these goals for patients in the UK in need of transplantation, we have developed guidelines for the selection of patients to the national waiting list based on the risk of death without a transplant and the ability of the procedure to improve the recipient's quality of life. Guidelines have been developed for both those with acute liver failure and chronic liver disease. Allocation will depend on matching of the donor liver to the recipient. The proposed system, to be introduced into the United Kingdom compares with some other systems, where different models for selection and allocation have been introduced.