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Assessing the outcome of organ allocation

choosing metrics

Schold, Jesse D.a,b

Current Opinion in Organ Transplantation: June 2019 - Volume 24 - Issue 3 - p 332–336
doi: 10.1097/MOT.0000000000000637

Purpose of review Organ allocation is a highly complex process with significant impact on outcomes of donor organs and end-stage organ disease patients. Policies governing allocation must incorporate numerous factors to meet stated objective. There have been significant alterations and ongoing discussion about changes in allocation policy for all solid organs in the United States. As with any policy change, rigorous evaluation of the impact of changes is important.

Recent findings This manuscript discusses metrics to consider to evaluate the impact of organ allocation policy that may be monitored on an ongoing basis including examples of research evaluating current policies. Potential metrics to evaluate allocation policy include the effectiveness, efficiency, equity, costs, donor rates, and transparency associated with the system.

Summary Ultimately, policies will often need to adapt to secular changes in donor and patient characteristics, clinical and technological advances, and overarching healthcare polices. Providing objective empirical evaluation of the impact of policies is a critical component for assessing quality of the allocation system and informing the effect of changes. The foundation of organ transplantation is built upon public trust and the dependence on the gift of donor organs, as such the importance of the most appropriate organ allocation policies cannot be overstated.

aDepartment of Quantitative Health Sciences

bCenter for Populations Health Research, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio, USA

Correspondence to Jesse D. Schold, Department of Quantitative Health Sciences, Cleveland Clinic, 9500 Euclid Avenue, JJN3-01, Cleveland, OH 44195, USA. Tel: +1 216 444 6254; fax: +216 445 2781; e-mail:

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