title: The influence of the organ allocation policy on a patient's chances of undergoing heart transplantation and the posttransplantation survival rate.
abstract: The Taiwan Organ Registry and Sharing Center (TORSC) was established by the Department of Health on June 6, 2002. According to the organ allocation policy, the computer-based organ-matching program began on April 1, 2005. In order to encourage organ donations, "donor hospitals" were given the highest priority. On October 1, 2010, the TORSC implemented a new allocation policy allowing highest priority to the most critically ill patients listed as 1A status. The aim of this study was to investigate the influence of the allocation policy on the likelihood of undergoing a heart transplantation (HTx) as well as the survival after the procedure. Based on the timeline of changes in the organ allocation policy, the patients were divided into three groups: "individual decision," "donor hospital first," and "urgency status first." We observed the waiting time of status 1A patients to decrease and their chance to receive a donor heart increase but their survival rate after HTx to decrease. Further research is needed to define the optimal organ allocation policy.
authors.affiliation: Department of Nursing, National Taiwan University Hospital, Taipei, Taiwan.
authors.forename: C-I
authors.initials: CI
authors.lastname: Tsao
authors.forename: N-K
authors.initials: NK
authors.lastname: Chou
authors.forename: N-H
authors.initials: NH
authors.lastname: Chi
authors.forename: S-C
authors.initials: SC
authors.lastname: Chen
authors.forename: W-J
authors.initials: WJ
authors.lastname: Ko
authors.forename: H-Y
authors.initials: HY
authors.lastname: Yu
authors.forename: Y-S
authors.initials: YS
authors.lastname: Chen
authors.forename: S-S
authors.initials: SS
authors.lastname: Wang
mesh_terms: D000328:Adult; D016638:Critical Illness; D005260:Female; D006333:Heart Failure / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D016027:Heart Transplantation / Q000009:adverse effects / Q000401:mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D016134:Organizational Policy; D018579:Patient Selection; D012042:Registries; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D016019:Survival Analysis; D015996:Survival Rate; D013624:Taiwan; D013997:Time Factors; D014019:Tissue Donors / Q000600:supply & distribution*; D009927:Tissue and Organ Procurement / Q000458:organization & administration*; D016896:Treatment Outcome; D014850:Waiting Lists