Patients on liver transplant waitlists are offered organs sequentially; the sickest patients in a local area are at the top of the waitlist and receive the highest priority. Although intuitively one would expect all transplant centers to be equally likely to accept a liver for their patient at the top, there were no data that had addressed whether this was the case. Furthermore, it was unknown how a center's decisions to accept or decline donor livers impacted whether patients at that center would subsequently die.
The authors examined data on all organ offers over a six-year period to evaluate factors associated with an organ offer being accepted, and how the probability an organ offer for a given patient would be accepted differed from center to center. The study shed light on a previously unidentified source of disparity in liver transplantation: transplant centers vary widely in the organs they accept, leaving many of the sickest patients to die while awaiting a life-saving organ. Even within a given local geographic area, some centers were far more likely to accept an organ, regardless of how sick the patient was.
Read the article in the Journal of Hepatology.