A Rational Approach to a Common Goal: The Equitable Distribution of Organs for Transplantation

The advent of brain death criteria and the increasing use of a new immunosuppressive agent, cyclosporine, have produced a quantum leap in the applicability of organ transplantation to the treatment of human disease. 1 Although the Uniform Anatomical Gift Act passed by Congress and adopted by all 50 states 2 has provided a legal basis for organ donation since 1973, there has been an increasingly severe shortage of organs for transplantation. 3 The growing acuteness of the problem, particularly with regard to kidney, heart, and liver transplantation, prompted congressional enactment of a National Organ Transplantation Act in 1984. The key element motivating this action was the universally accepted desirability of equitable distribution of all available organs in the United States. Unfortunately, government involvement in the practice of medicine is often followed by a deluge of well-intended but not necessarily well-informed regulations. Such regulations can, in the long run, produce results