title: Waiting for a thoracic transplant in Eurotransplant.
abstract: The prospects of patients on the thoracic waiting list are governed by the chance of receiving an organ in time and by the outcome of the transplantation. The former probability is determined by a triad of disease severity, resource size and allocation rules. The aim of this study was to provide an objective description of the distributional effects of the thoracic allocation system in Eurotransplant. It appears that the interpretation of waiting-list outflow indicators is not straightforward and that it is difficult to assess the fairness of an organ allocation system in the framework of changing donor-organ availability. The timing of listing for heart transplantation can substantially be improved; whether this is also true for lung transplantation cannot be determined from the available data. Allocation schemes cannot solve the problem of organ shortage; a shift of attention toward collaboration with procurement professionals is needed.
authors.affiliation: Eurotransplant International Foundation, Leiden, The Netherlands. jsmits@eurotransplant.nl
authors.forename: Jacqueline M A
authors.initials: JM
authors.lastname: Smits
authors.forename: Johan
authors.initials: J
authors.lastname: Vanhaecke
authors.forename: Axel
authors.initials: A
authors.lastname: Haverich
authors.forename: Erwin
authors.initials: E
authors.lastname: de Vries
authors.forename: Leo
authors.initials: L
authors.lastname: Roels
authors.forename: Guido
authors.initials: G
authors.lastname: Persijn
authors.forename: Gunther
authors.initials: G
authors.lastname: Laufer
mesh_terms: D000328:Adult; D005060:Europe; D015276:Health Care Rationing; D016027:Heart Transplantation / Q000706:statistics & numerical data*; D006801:Humans; D013997:Time Factors; D014019:Tissue Donors / Q000706:statistics & numerical data / Q000600:supply & distribution; D009927:Tissue and Organ Procurement / Q000458:organization & administration* / Q000639:trends*; D014850:Waiting Lists