Multi-organ Transplantation in the Setting of Scarcity
Multi-organ Transplantation in the Setting of Scarcity
Future efforts to inform best practices about identifying candidates who derive substantial benefit from MOT should take advantage of innovative epidemiological methods to reduce bias and adjust for confounding by indication. This work could take the form of prospective implementation of strict versus permissive criteria for MOT at different centers. The potential for randomized trials or quasi-experimental designs should also be carefully considered by stakeholders, including the Health Resources and Services Administration and the OPTN. Multi-center collaboration, perhaps within one OPTN region, will be essential to advance the level of evidence. The possible effect of multi-organ allocation on waiting times for disadvantaged groups such as sensitized patients should be assessed.
A Research Agenda
Future efforts to inform best practices about identifying candidates who derive substantial benefit from MOT should take advantage of innovative epidemiological methods to reduce bias and adjust for confounding by indication. This work could take the form of prospective implementation of strict versus permissive criteria for MOT at different centers. The potential for randomized trials or quasi-experimental designs should also be carefully considered by stakeholders, including the Health Resources and Services Administration and the OPTN. Multi-center collaboration, perhaps within one OPTN region, will be essential to advance the level of evidence. The possible effect of multi-organ allocation on waiting times for disadvantaged groups such as sensitized patients should be assessed.
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