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Community preferences for the allocation of solid organs for transplantation: A systematic review

Tong, Allison, Howard, Kirsten, Jan, Stephen, Cass, Alan, Rose, John, Chadban, Steven, Allen, Richard D. and Craig, Jonathan C. (2010). Community preferences for the allocation of solid organs for transplantation: A systematic review. Transplantation,89(7):796-805.

Document type: Journal Article

IRMA ID 84473293xPUB36
Title Community preferences for the allocation of solid organs for transplantation: A systematic review
Author Tong, Allison
Howard, Kirsten
Jan, Stephen
Cass, Alan
Rose, John
Chadban, Steven
Allen, Richard D.
Craig, Jonathan C.
Journal Name Transplantation
Publication Date 2010
Volume Number 89
Issue Number 7
ISSN 0041-1337   (check CDU catalogue open catalogue search in new window)
Scopus ID 2-s2.0-77950954826
Start Page 796
End Page 805
Total Pages 9
Place of Publication United States
Publisher Lippincott Williams & Wilkins
HERDC Category C1 - Journal Article (DIISR)
Abstract Background. Organs for transplantation are a scarce community resource but community preferences and how they are incorporated into allocation policies are unclear. This systematic review aimed to ascertain community preferences for organ allocation and the principles underpinning these preferences.

Methods. Medline, Embase, PsycINFO, EconLit, and gray literature databases were searched. Quantitative data were extracted, and a qualitative textual synthesis of the results and conclusions reported in each included study was performed.

Results. Fifteen studies involving more than 5563 respondents were included. Seven themes describing community preferences for organ allocation were identified: (1) maximum benefit, to achieve maximum health gain in recipient survival and quality of life; (2) social valuation, to base preferences on societal gain; (3) moral deservingness, to consider the "worthiness" of recipients based on their social standing and lifestyle decisions; (4) prejudice, to make a judgement based on personal ideologic viewpoints; (5) "fair innings," to provide an organ preferentially to the younger recipient giving opportunity for a "normal" life span and to those waiting for a first organ rather than a retransplant; (6) "first come, first served," to allocate the organ to recipients wait-listed the longest; and (7) medical urgency, to allocate based on illness severity and saving life.

Conclusions. Community preferences for organ allocation hinge on a complex balance of efficiency, social valuation, morality, fairness, and equity principles. Being a community-held resource, effective ways to identify and incorporate community preferences into allocation algorithms for solid organ transplantation are warranted.
DOI http://dx.doi.org/10.1097/TP.0b013e3181cf1ee1   (check subscription with CDU E-Gateway service for CDU Staff and Students  check subscription with CDU E-Gateway in new window)
 
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