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James Neuberger, MD

Arch Intern Med. 2003;163:1885.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

NOT surprisingly, there are few differences between our points of view. There is a clear agreement that all potential candidates for liver transplantation should have equal access to the pool of donated cadaveric livers, regardless of nonmedical criteria. (Here, the United Kingdom model of health care, by no means perfect, does offer significant advantages over an insurance-based system, which is in part dependent on the person's ability to pay.) I would argue that candidates should not be listed unless there is a strong likelihood that they will undergo transplantation, which means that access to the list must be controlled.

The optimal approach is to transplant a whole cadaveric graft into each recipient. Alternatives such as split livers, cut-down grafts, or grafts from non–heart-beating or living donors can help alleviate a shortfall, but taken together they are only a "second-best" approach. The public, politicians, and health care professionals . . . [Full Text of this Article]