New Perspectives and Approaches to Transplant Selection Committee.

Abstract

The transplant selection process for solid organ recipients relies on committee review and is susceptible to human nature and bias. The current model of selection committees has been under-examined and untested. Few studies exist on transplant selection committees. Barriers to quality decision-making have been studied in other industries. Lessons learned in other industries were explored and how they may be applied to a transplant selection committee. These include appointing an ethical representative or an advocate (pro) and dissenter (against) for discussion, adopting an ideal committee size/composition, and reviewing previous committee decisions (post-mortem). The transplant selection committee can function beyond a singular decision and be an opportunity to identify gaps in patients' treatment plans and available resources. Looking forward, a transplant selection committee that is more consistent, equitable, and protocolized can reduce bias, moral burden, and missed listings for our patients.