ABSTRACT
Department of Allergy, Immunology, and Respiratory Medicine, The Alfred Hospital, Monash University Clinical School, Melbourne, Victoria, Australia
INTRODUCTION
Donor organ shortage remains the major factor limiting the availability of lung transplantation to those with end-stage pulmonary and pulmonary vascular disease. Australia has a low rate of multiorgan donors (9.0 per million per year) but achieves very high rates of lung transplantation (up to 0.48 lung recipients per multiorgan donor). The preparedness to utilize marginal donors is a key factor in the high lung transplant rates. The system of organ allocation gives great discretion to the individual transplant centers and may be a key factor in the ability to seek and utilize marginal lung allografts. The organ allocation system needs to suit the overall system of delivery of medical services. Furthermore, it needs to match the overall expectations and aspirations of the population as well as complying with the relevant statutes. This chapter aims to review the Australian organ allocation system, in particular for thoracic organs, and put this into the broader perspective of the Australian health care system.
