Should Computers Decide Who Gets a Transplant?

The International Society for Heart and Lung Transplantation (ISHLT) announces evaluation of a new mathematical modeling system for lung allocation in the United States and the ethical issues surrounding organ allocation facing patients awaiting transplants.

Worldwide, patients in need of transplant are placed on a waiting list for donor lungs, using a wide variety of systems. In the United States, patients are currently assessed for organ allocation based on a new mathematical modeling system, in which patient information is entered into a computer database and donors are then matched with recipients based on specific characteristics. Two of the most important criteria are the chance of survival without the transplant and the projected condition of the patient post-transplant. The computer program then generates a list of patients that are ranked according to preset organ allocation policies.

Once selected, there are a number of tests that must be performed in order to evaluate whether the recipient may in fact receive the organ. Taking into consideration the novelty of the system, an international representation of ISHLT membership will convene to evaluate this new modeling system to determine its effectiveness.

"Many patients, families and those within the medical community have considered a first-come, first-served allocation system to be unfair, given that it did not take into account factors such as severity of a particular disease or how likely a patient would be to survive the transplant. This new system is an effort to give every patient an equal chance at transplant based on a number of varying factors," says Tom Waddell, M.D., Division of Thoracic Surgery, Toronto General Hospital, Canada and ISHLT Program Committee member.

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