US sets new priorities for liver transplants

BMJ 1996; 313 doi: (Published 30 November 1996) Cite this as: BMJ 1996;313:1350

The United States has announced a major shift in the way that waiting lists for liver transplantations are organised so that patients with acute liver failure will get priority over those with chronic conditions such as alcoholic liver disease, hepatitis B and C, and liver cancer. The decision has sparked controversy as most chronic liver conditions are associated with high risk behaviours, and rationing in this way could therefore imply a moral judgment.

The United Network for Organ Sharing, the organisation that maintains the national registry of donor organs and the waiting list, says that it has authorised the new rationing system to favour those patients who have the best prospects for survival rather than those who may have been on the waiting list longer but have a worse overall prognosis. …

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