Geographic disparities in transplantation.
| Autor: | Salvalaggio PR; Hospital Israelita Albert Einstein, Sao Paulo, Brazil. |
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| Jazyk: | angličtina |
| Zdroj: | Current opinion in organ transplantation [Curr Opin Organ Transplant] 2021 Oct 01; Vol. 26 (5), pp. 547-553. |
| DOI: | 10.1097/MOT.0000000000000914 |
| Abstrakt: | Purpose of Review: The Final Rule clearly states that geography should not be a determinant of a chance of a potential candidate being transplanted. There have been multiple concerns about geographic disparities in patients in need of solid organ transplantation. Allocation policy adjustments have been designed to address these concerns, but there is little evidence that the disparities have been solved. The purpose of this review is to describe the main drivers of geographic disparities in solid organ transplantation and how allocation policy changes and other potential actions could impact these inequalities. Recent Findings: Geographical disparities have been reported in kidney, pancreas, liver, and lung transplantation. Organ Procurement and Transplant Network has modified organ allocation rules to underplay geography as a key determinant of a candidates' chance of receiving an organ. Thus, heart, lung, and more recently liver and Kidney Allocation Systems have incorporated broader organ sharing to reduce geographical disparities. Whether these policy adjustments will indeed eliminate geographical disparities are still unclear. Summary: Modern allocation policy focus in patients need, regardless of geography. Innovative actions to further reduce geographical disparities are needed. (Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.) |
| Databáze: | MEDLINE |
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