title: Major advantages and critical challenge for the proposed United States heart allocation system.
abstract: The proposed new United States allocation system incorporates extensive research into an elegant plan designed to reduce wait list mortality while preserving post-transplant outcomes. All architects are to be congratulated. However, the future cannot be reliably modeled from the past as listing practices will evolve in response to new criteria. The new system should provide a major advance if and only if it is combined with a commitment to limit the number of listed patients overall and within each high priority status to the number that could reasonably undergo timely transplantation.
authors.affiliation: Advanced Heart Disease Section, Division of Cardiology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts. Electronic address: lstevenson@partners.org.
authors.forename: Lynne Warner
authors.initials: LW
authors.lastname: Stevenson
authors.affiliation: Artificial Heart Program, Department of Cardiothoracic Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.
authors.forename: Robert L
authors.initials: RL
authors.lastname: Kormos
authors.affiliation: Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, Ohio.
authors.forename: James B
authors.initials: JB
authors.lastname: Young
authors.affiliation: Division of Cardiothoracic Surgery, University of Alabama at Birmingham, Birmingham, Alabama.
authors.forename: James K
authors.initials: JK
authors.lastname: Kirklin
authors.affiliation: Post Heart Transplant Program, Stanford University, Stanford, California.
authors.forename: Sharon A
authors.initials: SA
authors.lastname: Hunt
mesh_terms: D006321:Heart; D006331:Heart Diseases; D016027:Heart Transplantation; D006801:Humans; D009927:Tissue and Organ Procurement; D014481:United States; D014850:Waiting Lists
keywords: ethics; heart donors; heart failure; heart transplantation; organ allocation; public policy