Hundreds of people each year undergo these transplants, and one in 10 dies when they could have lived longer without the surgery, the Tribune-Review reported this week in a three-day series. Some of the nation's top transplant surgeons said, the nation's liver allocation policies must be overhauled to stop transplant centers from doing surgeries on patients who don't need them. UNOS may revise rules.

Potential changes include limiting the liver transplant waiting lists to people who have reached a certain level of sickness and revising how those patients move up the list.
"This practice of using marginal organs in not very sick people is not benefiting patients for the most part and is hurting the people who really need them," said Dr. Richard B. Freeman Jr., transplant surgeon at Tufts-New England Medical Center in Boston.
Whatever changes are made must start with doctors, and then they can be enforced with federal regulations, said the nation's top health administrator, U.S. Health and Human Services Secretary Mike Leavitt. "We need to listen to them," Leavitt said during a visit to Pittsburgh this week. "Organ transplantation is a new enough discipline that we're all learning. There are probably places where we're not perfect in our execution as a society."
Leavitt said an overall system is in place to consider possible changes. That includes the United Network for Organ Sharing, or UNOS, which sets organ allocation rules under contract with the federal government.