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Race and Sex Disparities in Liver TransplantationProgress Toward Achieving Equal Access?
David A. Axelrod, MD, MBA;
Elizabeth A. Pomfret, MD, PhD
JAMA. 2008;300(20):2425-2426.
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Unique among medical specialties, the organ transplantation community has the obligation to explicitly allocate a very limited lifesaving resource. Liver transplantation offers the sole hope for long-term survival for patients with end-stage liver disease. Overall survival rates for transplantation now routinely exceed 90% at 1 year, even among patients with the most advanced liver failure, the majority of whom would die within months without a transplant.1-2 As stewards of a precious resource, the transplant community has a goal of achieving an equitable, transparent, and efficient system of organ allocation. Meeting these goals is crucial for maintaining confidence in the transplant system and encouraging organ donation.
Before 2002, deceased donor liver allografts were allocated by using a system that was loosely based on severity of illness and time spent waiting. Review of the national outcomes demonstrated that this system consistently failed . . . [Full Text of this Article]
Author Affiliations: Department of Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire (Dr Axelrod); and Department of Transplantation, Division of Surgery, Lahey Clinic Medical Center, Burlington, Massachusetts (Dr Pomfret).
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