Continuously Balancing the Ethics of Organ Allocation

In 2018, the US Organ Procurement and Transplantation Network (OPTN) approved a continuous distribution model as a framework for developing future organ allocation policy. This review assesses the ethical underpinnings and implications of the OPTN’s transition to the continuous distribution of organs.

Continuous distribution is as much a change in how organs are allocated as it is a change in how organ allocation policies are developed. The OPTN is transitioning all organ allocation systems to this new framework.

The OPTN changed its policy development process to distinguish ethical issues from operational and clinical decisions. Changes have been made to include more of the transplant community in the policy development process, solicit more specific feedback about value prioritization, understand the ethical tradeoffs in allocation, optimize policies to maximize the community’s ethical goals, and provide a more consistent experience for transplant candidates.