RESCUING PROMETHEUS - A POLICY PROPOSAL TO ALLEVIATE EXCESS-DEMAND FOR LIVER-TRANSPLANTATION

A growing demand for liver transplantation coupled with a static suppl y of organs results in an excess demand crisis. Excess demand for live r transplantation equals the number of patients left on the UNOS waiti ng list at the end of the year who have not expired, undergone transpl ant, or been withdrawn. Only in the arena of transplantation doses the United States medical community confront a true rationing dilemma ste mming from a scarcity of livers available for transplantation. An exce ss demand crisis intensifies debate in policy areas such as allocation and patient listing criteria. A cohesive rationing policy should mana ge both the demand for transplantation and the supply of transplantabl e organs. Demand-side management as applied to liver transplantation c ould decrease the incidence of critically ill patients waiting for tra nsplants, the number of retransplants performed and the total cost of transplantation to the health care system.