Organ Procurement and Transplantation -- Copyright -- REVIEWERS -- Foreword -- Preface -- Acronyms -- Contents -- Executive Summary -- CURRENT POLICIES AND PRACTICES -- CONCLUSIONS AND RECOMMENDATIONS -- The Need for Larger Organ Allocation Areas -- Appropriate Consideration of Patient Waiting Times -- Access to Organ Transplantation -- Organ Donation -- Organ Failure and Patient Survival -- Costs -- Oversight and Review -- 1 Introduction -- EVOLUTION OF THE FEDERAL SYSTEM OF ORGAN TRANSPLANTATION -- THE LATEST CALL FOR CHANGE: THE "FINAL RULE" -- Major Provisions of the Final Rule -- Procedural Requirements -- Policy Development -- Performance Goals -- THE ENSUING CONTROVERSY -- CHARGE TO THE COMMITTEE -- COMMITTEE METHODS AND FOCUS OF THE REPORT -- Focusing the Analysis on Livers -- ORGANIZATION OF THE REPORT -- 2 Current Policies and Practices -- ORGAN PROCUREMENT ORGANIZATIONS -- OPO Performance Standards -- THE ORGAN ALLOCATION PROCESS -- Listing Criteria, Patient Status -- Changes in Liver Allocation Policies -- CRITICISMS OF THE CURRENT POLICIES -- CONCLUSIONS -- 3 Access to Transplantation -- FACTORS AFFECTING ACCESS -- Socioeconomic Factors -- Biological Factors -- Other Factors -- POTENTIAL CLOSURE OF SMALL TRANSPLANT CENTERS -- POTENTIAL IMPLICATIONS OF MEDICAID PAYMENT POLICIES -- CONCLUSIONS -- 4 Organ Donation -- CURRENT STATUS -- Correlates of Donation -- PUBLIC AND PROFESSIONAL ATTITUDES -- Need for Educational Interventions -- REQUIRED REQUEST AND ROUTINE NOTIFICATION -- Additional Approaches to Improve Donation -- ASSESSING OPO PERFORMANCE -- CONCLUSIONS -- 5 Analysis of Waiting Times -- METHOD OF ANALYSIS -- RESULTS -- Status 1 -- Status 2 -- Statuses 3 and 4 -- Status Levels of Transplanted Patients -- OPO Size -- THE EFFECT OF SHARING -- SUMMARY -- CONCLUSIONS AND RECOMMENDATIONS -- 6 Organ Failure and Patient Survival.

ORGAN PRESERVATION AND DONOR INFLUENCES -- REVIEW OF LITERATURE -- ASSESSING THE IMPACT -- Computer Simulation Models -- POSTTRANSPLANT PATIENT SURVIVAL -- CONCLUSIONS -- 7 Costs -- DEFINING THE COMPONENTS OF COST -- INCREASED EXPENDITURES DUE TO TRANSPLANTATION OF SICKER PATIENTS -- INCREASED EXPENSES FOR ORGAN ACQUISITION -- CONCLUSION -- 8 Oversight and Review -- ROLE OF THE FEDERAL GOVERNMENT -- Performance Measures -- Independent Scientific Review -- DATA COLLECTION, ANALYSIS, AND DISSEMINATION -- References -- A Data Sources and Methods -- TESTIMONY AND PUBLIC INPUT -- OTHER PARTICIPANTS AND CONTRIBUTORS -- LITERATURE REVIEW -- STATISTICAL ANALYSIS -- Analysis of Waiting Time -- Parameter Estimation -- Numerical Quadrature -- Hazard Rates and Cumulative Survival -- ANALYSIS OF COSTS -- B Guide to Summary Tables -- DEFINITIONS OF TERMS THAT APPEAR AS TABLE HEADINGS -- C Current Liver Allocation Policies -- POLICY 3.6 ORGAN DISTRIBUTION -- D The ''Final Rule" -- DEPARTMENT OF HEALTH AND HUMAN SERVICES 42 CFR PART 121 ORGAN PROCUREMENT AND TRANSPLANTATION NETWORK -- FINAL RULE (63... -- PART 121 ORGAN PROCUREMENT AND TRANSPLANTATION NETWORK -- E Committee and Staff Biographies -- COMMITTEE BIOGRAPHIES -- IOM PROJECT STAFF -- Index.