UNIQUE AMONG MEDICAL SPECIALTIES, THE ORGAN transplantation community has the obligation to explicitly allocate a very limited lifesaving resource. Liver transplantation offers the sole hope for long-term survival for patients with end-stage liver disease. Overall survival rates for transplantation now routinely exceed 90% at 1 year, even among patients with the most advanced liver failure, the majority of whom would die within months without a transplant.1'2 As stewards of a precious resource, the transplant community has a goal of achieving an equitable, transparent, and efficient system of organ allocation. Meeting these goals is crucial for maintaining confidence in the transplant system and encouraging organ donation.
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