Book contents
- Negotiating Values
- Negotiating Values
- Copyright page
- Dedication
- Contents
- Figure and Tables
- Preface and Acknowledgments
- Abbreviations
- 1 Rare Opportunity
- 2 Origins of Continuous Distribution
- 3 Managing the Implementation of Organizational Change
- 4 Varieties of Expertise
- 5 Public (Community) Participation in Policymaking
- 6 Evidence and Values in Continuous Distribution Design
- 7 Organ Acceptance and Continuous Distribution
- 8 Constructed Collaboration
- Appendix
- References
- Index
2 - Origins of Continuous Distribution
Published online by Cambridge University Press: 30 November 2025
Book contents
- Negotiating Values
- Negotiating Values
- Copyright page
- Dedication
- Contents
- Figure and Tables
- Preface and Acknowledgments
- Abbreviations
- 1 Rare Opportunity
- 2 Origins of Continuous Distribution
- 3 Managing the Implementation of Organizational Change
- 4 Varieties of Expertise
- 5 Public (Community) Participation in Policymaking
- 6 Evidence and Values in Continuous Distribution Design
- 7 Organ Acceptance and Continuous Distribution
- 8 Constructed Collaboration
- Appendix
- References
- Index
Summary
The United Network for Organ Sharing (UNOS) began as the network administrative organization (NAO) overseeing the voluntary sharing of organs among transplant centers. It subsequently became the administrator of the Organ Procurement and Transplantation Network (OPTN), which Congress created to allocate deceased-donor organs when it nationalized them in 1984. The OPTN continuously makes incremental changes to organ allocation rules, raising concerns that the path dependence of allocation rules would hinder more radical change. Under pressure from the federal government, the OPTN gradually reduced the role of geographic boundaries in its allocation rules. However, it also introduced other categories so that allocation rules became increasingly complex. It initially considered continuous distribution (CD), a radical change, as an alternative for eliminating historical geographic boundaries. The OPTN subsequently committed to implementing CD for all solid organs because it offered improvements in efficiency, equity, and transparency, and because its relative simplicity would allow more expeditious incremental changes to allocation rules.
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- Negotiating ValuesImplementing Change in the Allocation of Transplant Organs, pp. 18 - 52Publisher: Cambridge University PressPrint publication year: 2025
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