Kasiske Bertram L, Pyke Joshua, Snyder Jon J
Hennepin County Medical Center.
Scientific Registry of Transplant Recipients, Chronic Disease Research Group, Hennepin Healthcare Research Institute.
Curr Opin Organ Transplant. 2020 Apr;25(2):115-121. doi: 10.1097/MOT.0000000000000733.
The Scientific Registry of Transplant Recipients (SRTR) supports the Organ Procurement and Transplantation Network (OPTN) efforts to better align liver allocation with the Final Rule. Here, we review recent literature related to removing place of residence or listing from organ allocation policy and describe how SRTR may help advance the OPTN policy development process.
In December 2018, the OPTN Board of Directors endorsed the recommendation from OPTN's ad hoc Committee on Geography to develop organ-allocation policies that do not rely on geographic boundaries, called 'continuous distribution.' Many objections to wider organ distribution stem from efforts to address inequities in allocation for populations within geographic regions rather than for individual patients. A continuous distribution system could equitably address the needs of individual patients, merging ethical-medical urgency with geographic feasibility.
The effort to remove geographic boundaries from organ distribution and allocation has been controversial. An integrated continuous distribution system may help focus the debate on priorities that matter most to patients.
移植受者科学注册系统（SRTR）支持器官获取与移植网络（OPTN）为使肝脏分配更好地符合最终规则所做的努力。在此，我们回顾近期与从器官分配政策中去除居住地或登记信息相关的文献，并描述SRTR如何助力推进OPTN的政策制定进程。
2018年12月，OPTN董事会认可了OPTN地理特设委员会的建议，即制定不依赖地理边界的器官分配政策，称为“连续分配”。许多对更广泛器官分配的反对意见源于为解决地理区域内人群而非个体患者分配不平等问题所做的努力。连续分配系统可以公平地满足个体患者的需求，将伦理 - 医学紧迫性与地理可行性相结合。
从器官分配中去除地理边界的努力一直存在争议。一个综合的连续分配系统可能有助于将辩论聚焦于对患者最重要的优先事项上。
