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How Do We Determine Futility for Patients in Need of Liver Transplantation?

  • Liver Transplantation (D Mulligan, Section Editor)
  • Published:
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Abstract

Futility remains poorly defined in healthcare and entails a large portion of healthcare spending. With limited resources, the field of liver transplantation attempts to minimize cases of futility but struggles to balance the difficulty to provide a life-saving procedure to an increasingly sick patient population as seen with rising Model-for-End-Stage-Liver Disease (MELD) scores. This paper aims to explore the historical context of organ allocation, utilize the medical ethical principles for organ allocation, and review the literature on how to improve transplant outcomes and reduce ‘futile’ cases. In addition, the piece will also delve into the application of palliative care in the management of both listed patients and those who are deemed futile. As transplant centers continue to be challenged with higher expectations and sicker patients, the field needs to develop a consensus statement on how to define futility and determine what measurements should be used to assess centers’ transplant performance.

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References

Papers of particular interest, published recently, have been highlighted as: • Of importance

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Authors and Affiliations

  1. Section of Digestive Diseases, Yale School of Medicine, 333 Cedar St, LMP 1080, New Haven, CT, 06510, USA

    Adelina Hung, Matthew McConnell & Brett E. Fortune

Authors
  1. Adelina Hung
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  2. Matthew McConnell
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  3. Brett E. Fortune
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Corresponding author

Correspondence to Brett E. Fortune.

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Conflict of Interest

Adelina Hung, Brett Fortune, and Matthew McConnell declare no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

Additional information

Adelina Hung and Matthew McConnell contributed equally to this work.

This article is part of the Topical Collection on Liver Transplantation

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Hung, A., McConnell, M. & Fortune, B.E. How Do We Determine Futility for Patients in Need of Liver Transplantation?. Curr Transpl Rep 3, 319–324 (2016). https://doi.org/10.1007/s40472-016-0118-5

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  • DOI: https://doi.org/10.1007/s40472-016-0118-5

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