Ethical Considerations for Heart Organ Allocation Current Landscape and Future Policy Guidance

Updated: May 28, 2026

There are 4 groups of decision-makers in transplantation: (1) the donor and donor family, (2) transplant recipient, (3) clinicians, and (4) society. Each of these decision-makers has interests and motivations for participating in an organized allocation system, particularly in the setting of organ scarcity.

Donor hearts are a scarce resource, making responsible stewardship, fair distribution, and attention to disparities in access such as socioeconomic and geographic factors, essential for ethical allocation and public trust.
Evolving policies and technological advances have expanded donor pools and geographic sharing, but have also introduced new costs and barriers, highlighting the need for ongoing evaluation to ensure equity and effectiveness.
Future improvements require integrating ethical principles through multidisciplinary collaboration, bioethics education, and data-driven modeling, with a focus on improving access for all.

Read the full article in Circulation »

Ethical Considerations for Heart Organ Allocation: Current Landscape and Future Policy Guidance

In this video, Writing Committee Chair Prateeti Khazanie, MD, MPH, FAHA, an advanced heart failure and transplant cardiologist at the University of Colorado, introduces a new scientific statement from the American Heart Association addressing ethical considerations in heart transplant allocation. She highlights key challenges in ensuring fair, transparent decision-making amid limited donor supply and evolving policies, and their implications for clinicians and patients. The statement brings together multidisciplinary expertise to support transparent, equitable, and ethically grounded decision-making and to inform future transplant policy.

Ethical Considerations for Heart Organ Allocation: Current Landscape and Future Policy Guidance

Supporting Materials

Recommended Reading

Related Resources