In Transplant We Trust? Perspectives on the Erosion of Trust in the United States Transplant System.

The US national organ transplant program was established more than 50 years ago, founded on the tenets of fairness, equity, and safety. Public trust is paramount to the success of every aspect of organ transplantation, including donor registration, organ procurement organization practices, donor hospital partnerships, and allocation policy. This perspective evaluates the status of public trust in organ transplants in the context of new and concerning developments in US practices and government responses. Our focus is on the potential impacts on heart transplantation, specifically on waitlist mortality, especially for patients without an alternative option of durable mechanical circulatory support.