Evidence map›Paper›PMID 41848624›Full record

ArticleClinical transplantation2026

Demand, Waitlisting and Transplantation Around the World: The Axiomatic View of Scarcity in Liver Transplantation.

Charles Thomas, Patrick O'Regan, Sara Shahrestani, Ken Liu, Simone Strasser, Henry C Pleass, Michael D Crawford, Carlo Pulitano, Jerome M Laurence

Abstract read
In one paragraph

Article in Clinical transplantation, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Charles ThomasAustralian National LT Unit, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia.
Patrick O'ReganAustralian National LT Unit, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia.
Sara ShahrestaniSydney Medical School, University of Sydney, Sydney, New South Wales, Australia.ORCID https://orcid.org/0000-0002-5122-1730
Ken LiuAustralian National LT Unit, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia.
Simone StrasserAustralian National LT Unit, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia.
Henry C PleassAustralian National LT Unit, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia.
Michael D CrawfordAustralian National LT Unit, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia.
Carlo PulitanoAustralian National LT Unit, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia.
Jerome M LaurenceAustralian National LT Unit, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia.ORCID https://orcid.org/0000-0002-1123-0122

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionLiver transplantation (LT) significantly improves survival and quality of life for patients with end-stage liver disease. Whilst it is believed that need for LT vastly exceeds organ supply, quantifying the demand accurately is challenging. The performance metrics of the transplant system, such as waitlist mortality, may be misleading as they capture only patients who are referred, evaluated and listed for LT. Although means of increasing organ availability are available, they have financial costs and may be technically and ethically challenging (such as live donation and normothermic regional perfusion). The imperative to embrace these techniques can be obscured if the waitlist is assumed to be representative of the actual demand for transplantation.

methodsAn international comparative analysis of transplantation, donation and waitlist outcomes versus measures of demand for LT was performed using publicly available data.

resultsThe comparative analysis revealed no correlation between disease prevalence and waitlist metrics across jurisdictions internationally, suggesting that waitlisting practices are largely independent of actual LT demand and are constrained by other factors.

conclusionAdult LT systems globally are supply driven and uncorrelated to demand, implying that all jurisdictions are unable to meet the demand of their community and are limited by the supply of viable organs. The study underscores the inadequacy of waitlist data in representing true demand and highlights the need for improved data to inform LT policy and practice to improve access to this life-enhancing and life-saving treatment.

Indexed as

End Stage Liver DiseaseHealth Services Needs and DemandLiver TransplantationTissue and Organ ProcurementTissue DonorsWaiting ListsHumansPrognosisauxiliarycirrhosisfulminant hepatic failureLT (liver transplantation)organ allocationorgan procurement and transplantation network (OPTN)

Identifiers

PMID41848624
PMCPMC12998500

What OpenQuestion holds

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LicenceCC BY-NC
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.