Because of those exact concerns that you mentioned about the complaints and or critiques of UNOS a massive rule change that revised transplant criteria and donor criteria was passed around like 2022. All of the participating hospitals that I know of are still in the process of adapting to that rule change because it takes forever for these institutions to adapt their day-to-day protocols to be in compliance with the network rules. When I talk to patients and when I talk to providers they are still of the opinion that we are collecting data on what the overall change has been to the patient population as a result of the change in rules.

Public health is not sexy and is always slow. It takes time to collect data it takes time to analyze results it takes time to change institutional paradigms. It's not good enough to simply change things just for sake of them being different. We have to make intentional choices about improving transplant care.

And all of this is completely pointless to talk about because hospitals and research units are being gutted, left to die like their patients.