{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,6]],"date-time":"2026-09-06T17:52:45Z","timestamp":1788717165579,"version":"build-2803163510"},"reference-count":12,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"8","license":[{"start":{"date-parts":[[2015,9,1]],"date-time":"2015-09-01T00:00:00Z","timestamp":1441065600000},"content-version":"tdm","delay-in-days":39,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["RC1 1RC1DK086450\u201301"],"award-info":[{"award-number":["RC1 1RC1DK086450\u201301"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000016","name":"U.S. Department of Health and Human Services","doi-asserted-by":"publisher","award":["#HHSH250201000018C"],"award-info":[{"award-number":["#HHSH250201000018C"]}],"id":[{"id":"10.13039\/100000016","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["K24DK101828"],"award-info":[{"award-number":["K24DK101828"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Liver Transpl"],"published-print":{"date-parts":[[2015,8]]},"abstract":"<jats:p>Concerns have been raised that optimized redistricting of liver allocation areas might have the unintended result of shifting livers from better\u2010performing to poorer\u2010performing organ procurement organizations (OPOs). We used liver simulated allocation modeling to simulate a 5\u2010year period of liver sharing within either 4 or 8 optimized districts. We investigated whether each OPO's net liver import under redistricting would be correlated with 2 OPO performance metrics (observed to expected liver yield and liver donor conversion ratio), along with 2 other potential correlates (eligible deaths and incident listings above a Model for End\u2010Stage Liver Disease score of 15). We found no evidence that livers would flow from better\u2010performing OPOs to poorer\u2010performing OPOs in either redistricting scenario. Instead, under these optimized redistricting plans, our simulations suggest that livers would flow from OPOs with more\u2010than\u2010expected eligible deaths toward those with fewer\u2010than\u2010expected eligible deaths and that livers would flow from OPOs with fewer\u2010than\u2010expected incident listings to those with more\u2010than\u2010expected incident listings; the latter is a pattern that is already established in the current allocation system. Redistricting liver distribution to reduce geographic inequity is expected to align liver allocation across the country with the distribution of supply and demand rather than transferring livers from better\u2010performing OPOs to poorer\u2010performing OPOs. <jats:italic toggle=\"yes\">Liver Transpl 21:1031\u20101039, 2015<\/jats:italic>. \u00a9 2015 AASLD.<\/jats:p>","DOI":"10.1002\/lt.24171","type":"journal-article","created":{"date-parts":[[2015,5,19]],"date-time":"2015-05-19T23:53:14Z","timestamp":1432079594000},"page":"1031-1039","source":"Crossref","is-referenced-by-count":26,"title":["Liver sharing and organ procurement organization performance under redistricted allocation"],"prefix":"10.1097","volume":"21","author":[{"given":"Sommer E.","family":"Gentry","sequence":"first","affiliation":[{"name":"Department of Surgery,Johns Hopkins University School of Medicine,Baltimore,MD"},{"name":"Department of Mathematics,United States Naval Academy,Annapolis,MD"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric K. H.","family":"Chow","sequence":"additional","affiliation":[{"name":"Department of Surgery,Johns Hopkins University School of Medicine,Baltimore,MD"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Allan","family":"Massie","sequence":"additional","affiliation":[{"name":"Department of Surgery,Johns Hopkins University School of Medicine,Baltimore,MD"},{"name":"Department of Epidemiology,Johns Hopkins School of Public Health,Baltimore,MD"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xun","family":"Luo","sequence":"additional","affiliation":[{"name":"Department of Surgery,Johns Hopkins University School of Medicine,Baltimore,MD"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eugene","family":"Shteyn","sequence":"additional","affiliation":[{"name":"Scientific Registry of Transplant Recipients,Minneapolis Medical Research Foundation,Minneapolis,MN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joshua","family":"Pyke","sequence":"additional","affiliation":[{"name":"Scientific Registry of Transplant Recipients,Minneapolis Medical Research Foundation,Minneapolis,MN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Zaun","sequence":"additional","affiliation":[{"name":"Scientific Registry of Transplant Recipients,Minneapolis Medical Research Foundation,Minneapolis,MN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jon J.","family":"Snyder","sequence":"additional","affiliation":[{"name":"Scientific Registry of Transplant Recipients,Minneapolis Medical Research Foundation,Minneapolis,MN"},{"name":"Departments of Epidemiology and Community Health,Hennepin County Medical Center, University of Minnesota,Minneapolis,MN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ajay K.","family":"Israni","sequence":"additional","affiliation":[{"name":"Scientific Registry of Transplant Recipients,Minneapolis Medical Research Foundation,Minneapolis,MN"},{"name":"Departments of Epidemiology and Community Health,Hennepin County Medical Center, University of Minnesota,Minneapolis,MN"},{"name":"Department of Medicine,Hennepin County Medical Center, University of Minnesota,Minneapolis,MN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bert","family":"Kasiske","sequence":"additional","affiliation":[{"name":"Scientific Registry of Transplant Recipients,Minneapolis Medical Research Foundation,Minneapolis,MN"},{"name":"Department of Medicine,Hennepin County Medical Center, University of Minnesota,Minneapolis,MN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dorry L.","family":"Segev","sequence":"additional","affiliation":[{"name":"Department of Surgery,Johns Hopkins University School of Medicine,Baltimore,MD"},{"name":"Department of Epidemiology,Johns Hopkins School of Public Health,Baltimore,MD"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2015,7,24]]},"reference":[{"key":"lt24171-bib-0001-20240115","doi-asserted-by":"crossref","first-page":"747","DOI":"10.1002\/lt.21158","article-title":"Geographic disparities in deceased donor liver transplantation within a single UNOS region","volume":"13","year":"2007","journal-title":"Liver Transpl"},{"key":"lt24171-bib-0002-20240115","doi-asserted-by":"crossref","first-page":"2470","DOI":"10.1111\/j.1600-6143.2006.01508.x","article-title":"Geographic differences in event rates by Model for End\u2010Stage Liver Disease score","volume":"6","year":"2006","journal-title":"Am J Transplant"},{"key":"lt24171-bib-0003-20240115","doi-asserted-by":"crossref","first-page":"1322","DOI":"10.1056\/NEJM199810293391811","article-title":"Geographic favoritism in liver transplantation--unfortunate or unfair?","volume":"339","year":"1998","journal-title":"N Engl J Med"},{"key":"lt24171-bib-0004-20240115","doi-asserted-by":"crossref","first-page":"479","DOI":"10.1097\/TP.0b013e3182066275","article-title":"Geographic inequity in access to livers for transplantation","volume":"91","year":"2011","journal-title":"Transplantation"},{"key":"lt24171-bib-0005-20240115","doi-asserted-by":"crossref","first-page":"2362","DOI":"10.1111\/j.1600-6143.2011.03735.x","article-title":"MELD exceptions and rates of waiting list outcomes","volume":"11","year":"2011","journal-title":"Am J Transplant"},{"key":"lt24171-bib-0006-20240115","doi-asserted-by":"crossref","first-page":"2113","DOI":"10.1111\/j.1600-6143.2009.02744.x","article-title":"Geographic variation in organ availability is responsible for disparities in liver transplantation between Hispanics and Caucasians","volume":"9","year":"2009","journal-title":"Am J 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the context of organ donation","volume":"12","year":"2012","journal-title":"Am J Transplant"},{"key":"lt24171-bib-0012-20240115","doi-asserted-by":"crossref","first-page":"293","DOI":"10.1002\/lt.24074","article-title":"Liver sharing and organ procurement organization performance","volume":"21","year":"2015","journal-title":"Liver Transpl"},{"key":"lt24171-bib-0016-20240115","doi-asserted-by":"crossref","first-page":"94","DOI":"10.1097\/01.TP.0000443223.89831.85","article-title":"Variation in access to the liver transplant waiting list in the United States","volume":"98","year":"2014","journal-title":"Transplantation"}],"container-title":["Liver 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