Are There Too Many US Transplantation Centers? Some Experts Suggest Fewer, Cheaper, and Better

WHILE the increase in the number of transplantation centers across the United States may help provide easier and more equitable patient access to services, this growth is not always associated with good outcomes or with the most cost-effective use of donor organs and health care dollars. Such were the views a panel of experts presented at the first joint annual meeting, held in Washington, DC, of the United Network for Organ Sharing (UNOS) and the US Department of Health and Human Services' Division of Organ Transplantation. "Not everybody who wants a center can have one, and we better start to accept this at the outset of discussion," said panelist Charles M. Miller, MD, director of the liver transplant program at Mount Sinai Medical Center, New York, NY. Any hospital with at least one UNOS-approved transplantation program in association with an organ procurement officer and a tissue-typing laboratory can call itself