Use of the Internet by United States Heart Transplant Centers to Promote Transparency in the Process of Patient Selection

Organ transplantation is an ethically complex technology, in part because organs are very scarce and supply does not meet demand. Organ allocation must use a process that is fair, and the process should be open for public review and revision. We explored the transparency of the heart transplant patient selection process in the United States terming transparency as hospital use of their transplant program Web site to disclose their policies to potential patients. The Web sites of all heart transplant centers belonging to the U.S. Organ Procurement and Transplantation Network were reviewed for content pertaining to patient selection criteria for placement on the transplant waiting list. All 132 heart transplant centers have a Web site that discusses their transplant program; however, 84% (n = 111) do not publish their medical listing criteria on their Web site. Only 15% (n = 20) expressly indicate the requirement for a psychosocial evaluation. Few centers (n = 9) utilize their Web site to discuss use of a formal data review committee to decide which patients to list for transplantation. In order to demystify and correct false assumptions about the transplant listing process, wait listing criteria should be transparent to the public and Internet disclosure can facilitate this end. Our findings lay the foundation for future prospective studies.