Researchers: Katvan Eyal¹, Ashkenazi Tamar², Doron Israel³, Shnoor Boaz¹, Mor Eytan⁴

Background: As of April 2014 the age limitation on candidates listed for organ transplantation has been abolished following the recommendations of a Public Committee. The underlying sociological conditions of this change, which include the aging of Israeli society, a concomitant demand increase for organs and better transplant success rates for older recipients, indicate the need to protect the latter from ageism.
Objectives: To provide data regarding the implementation of the policy change; its impact on organ allocation, waiting time, and the emotional state of candidates and organ recipients; and to analyze the opinions of medical staff and patients regarding the change.

Objectives: To provide data regarding the implementation of the policy change; its impact on organ allocation, waiting time, and the emotional state of candidates and organ recipients; and to analyze the opinions of medical staff and patients regarding the change.

Method: The project used mixed research methods. In the first stage data held by the National Transplant Center was analyzed. The second stage consisted of a qualitative study, including 32 in-depth interviews with medical staff, organ-recipients, and transplant-candidates. In the third stage results from a multiple questioner were obtained from organ-recipients. Quantitative statistical methods were used to analyze the quantitative data of the first and third stages. Data from the second stage were analyzed via qualitative phenomenological methods.

Findings: The statistical data shows a significant increase in the percentage of transplants among older people. The data also shows a slight increase in the median waiting time for transplant.
Medical staff interviews revealed three main themes:
1. Positive acceptance of the new policy;
2. concerns and problems;
3. the policy change influenced the organ transplant allocation system and patient-doctor relationships.
The findings from the patients’ interviews indicated:
1. they had been uninformed regarding the policy change;
2. positive acceptance of the change among most patients. The elderly recipients maintained that priority should be given to younger patients.

Conclusions: The main conclusion is that the new policy gave older patients access to organ donations, a change which both medical staff and patients, welcomed. However, some of the medical staff is concerned by the medical and normative implications of the new policy, and these concerns question the moral justice for the full application of the new policy.

Recommendations: The project proposes means of guaranteeing the implementation of the policy by using objective criteria (as the frailty index) for allocating organs, its dissemination among patients and medical staff, and further research concerning the new policy's implications.

Research end date: 03/2019