Objective: To explore the public preference in determining the selection criteria for recipients of scarce donor livers.
Design: Structured interview survey.
Setting: Hong Kong community.
Participants: Participants from Hong Kong households, randomly drawn from 18 districts in Hong Kong by the Census and Statistics Department.
Main outcome measures: Age of patients, causes of liver failure, capacity for survival and benefit, time spent on the waiting list, and transplantation status.
Results: A total of 281 participants were recruited with the response rate of 26.2%. In all sections of the questionnaire, there was a strong preference for the young over the old, non-drinkers over drinkers, those more likely to survive, those who had waited longest on the list, and primary candidates over re-transplant candidates. Approximately 91% of participants agreed or strongly agreed that priority should be given to patients most likely to survive and benefit from a liver transplant, and 39% of participants also ranked 'survival and benefit' as the most important criterion in determining allocation of donor livers. Nonetheless when participants were asked to allocate a finite number (100) of donor livers to two groups of individuals with different characteristics in a set of eight hypothetical scenarios, they preferred giving priority to patients who had waited longer on the waiting list.
Conclusion: Although comparatively the general public surveyed had dominant preferences to maximise benefit and survival, they were unlikely to rely on one criterion for allocation. Overall cost-effectiveness of the intervention was not the sole deciding factor.