title: Competition in liver transplantation: helpful or harmful?
abstract: Improved outcomes of liver transplantation have led to increases in the numbers of US transplant centers and candidates on the list. The resultant and ever-expanding organ shortage has created competition among centers, especially in regions with multiple liver transplant programs. Multiple reports now document that competition among the country's transplant centers has led to the listing of increasingly high-risk patients and the utilization of more marginal liver allografts. The transplant and medical communities at large should carefully re-evaluate these practices and promote innovative approaches to restoring trust in the allocation of donor organs and confirming that there is nationwide conformity in the guidelines used for evaluating and listing potential candidates for this scarce resource.
authors.affiliation: Division of Organ Transplantation, Department of Surgery, Rhode Island Hospital, Alpert Medical School of Brown University, Providence, RI.
authors.forename: Reza F
authors.initials: RF
authors.lastname: Saidi
authors.forename: Moaven
authors.initials: M
authors.lastname: Razavi
authors.forename: A Benedict
authors.initials: AB
authors.lastname: Cosimi
authors.forename: Dicken S C
authors.initials: DS
authors.lastname: Ko
mesh_terms: D003657:Decision Making; D058625:End Stage Liver Disease / Q000601:surgery; D005843:Geography; D006801:Humans; D016031:Liver Transplantation / Q000191:economics; D017063:Outcome Assessment, Health Care; D040841:Resource Allocation; D014019:Tissue Donors / Q000600:supply & distribution; D009927:Tissue and Organ Procurement / Q000379:methods*; D016896:Treatment Outcome; D014481:United States; D014850:Waiting Lists