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Questions of accountability and transparency in the US organ donation and transplantation system

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  1. Becker, Y. Curr. Transplant. Rep. (2022).

  2. MacMurdo, M. G. & Sweet, S. C. Ann. Am. Thorac. Soc. 17, 795–799 (2020).

    Article  Google Scholar 

  3. Department of Health and Human Services. National Archives Code of Federal Regulations (accessed 19 April 2022).

  4. Grassley, C. E. et al. United States Senate Committee on Finance,%20Wyden,%20Young,%20Cardin%20to%20UNOS%20(Information%20Request%20on%20Organ%20Transplant%20System).pdf (10, February 2020).

  5. Grassley, C. Chuck Grassley (4 February 2021).

  6. Office of Congressional and Government Affairs. National Academies of Sciences, Medicine, and Engineering (2019).

  7. National Research Council. (The National Academies Press, 2022).

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All authors contributed equally to this Correspondence.

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Correspondence to Macey L. Levan.

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Competing interests

D.S. was a member of the NASEM ad hoc committee that authored the report A Fairer and More Equitable, Cost-Effective, and Transparent System of Donor Organ Procurement, Allocation, and Distribution. M.L.L. and S.K. provided consultative services to NASEM to assist with the report. M.L.L. is a former member of the OPTN and UNOS board of directors.

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Levan, M.L., Klitenic, S., Massie, A. et al. Questions of accountability and transparency in the US organ donation and transplantation system. Nat Med (2022).

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