Geographic Favoritism in Liver Transplantation — Unfortunate or Unfair?

Donna Shalala, secretary of the Department of Health and Human Services, recently proposed regulations that would fundamentally change the way in which cadaveric livers for transplantation are allocated in the United States. Currently, livers are distributed first according to geographic region and then according to medical criteria. As a result, patients' chances of living or dying are shaped more by where they live than by how urgently they need a transplant. This system also allows some patients to increase their odds of receiving an organ by listing themselves at more than one transplantation center in different regions, a practice known . . .