Current State of Multiorgan Transplantation and Implications for Future Practice and Policy

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2 Scopus citations


The incidence of kidney dysfunction has increased in liver transplant and heart transplant candidates, reflecting a changing patient population and allocation policies that prioritize the most urgent candidates. A higher burden of pretransplant kidney dysfunction has resulted in a substantial rise in the utilization of multiorgan transplantation (MOT). Owing to a shortage of available deceased donor kidneys, the increased use of MOT has the potential to disadvantage kidney-alone transplant candidates, as current allocation policies generally provide priority for MOT candidates above all kidney-alone transplant candidates. In this review, the implications of kidney disease in liver transplant and heart transplant candidates is reviewed, and current policies used to allocate organs are discussed. Important ethical considerations pertaining to MOT allocation are examined, and future policy modifications that may improve both equity and utility in MOT policy are considered.

Original languageEnglish (US)
Pages (from-to)561-569
Number of pages9
JournalAdvances in Chronic Kidney Disease
Issue number6
StatePublished - Nov 2021


  • Multiorgan transplantation
  • Organ allocation
  • Simultaneous heart-kidney transplantation
  • Simultaneous liver-kidney transplantation
  • Transplant ethics

ASJC Scopus subject areas

  • Nephrology


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