Current allocation policies and disparities within liver and kidney transplantation

Through wide-spanning policy changes, disparities in access to transplantation and transplantation rates have been created, in both the past and current liver and kidney transplant allocation systems. These disparities mainly affect women and minorities, and can be lessened, and in some ways eliminated, through concentrated efforts by policy makers and public health officials. The current waitlist burdens, allocation policies and transplantation rates, are described in this essay with the purpose of identifying weak areas in the current system where policy amendments and public health interventions would be most beneficial. Proposed changes to the current allocation policy in liver and kidney transplantation include the redrawing of borders in which organs are shared and altering the MELD score for women to better reflect smaller physical traits of women, in the liver allocation system, and expanding the role of kidney paired donation in renal transplantation. In conjunction with policy changes, interventions that increase education and awareness of the need for living donor organs and the importance of decreasing Hepatitis C transmission can be directed to problematic communities. While the solutions for observed disparities in both liver and kidney transplantation may not be obvious, understanding the epidemiologic factors that lead to observed disparities in organ allocation systems for liver and kidney transplantation are of paramount public health importance because they have the potential to limit millions of people from obtaining a life-saving therapy